Second-trimester maternal serum inhibin A concentration as an early marker for preeclampsia.
OBJECTIVE
Maternal serum inhibin A concentration is elevated in established preeclampsia. The aim of this study was to investigate whether this relationship antedates the appearance of the classic signs of preeclampsia.


METHODS
A retrospective analysis was performed on trisomy 21 screening data from 685 women at between 15 and 19 weeks' gestation. The main outcome measures were preeclampsia and small for gestational age (<5th percentile) infants.


RESULTS
Preeclampsia developed in 35 women (5.5%). Women with inhibin A concentration >2.0 multiples of the median were significantly more likely to acquire preeclampsia (P <.00001) and to be delivered of a small for gestational age infant (<5th percentile, P <.00001) than were women with inhibin A concentration </=2.0 multiples of the median. The odds ratios were 9.4 (95% confidence interval 4.6-19.3) for development of preeclampsia and 18.2 (95% confidence interval 6. 0-54.8) for preeclampsia necessitating delivery at <37 weeks' gestation. The association remained statistically significant for nulliparous women.


CONCLUSIONS
Elevated maternal inhibin A concentration in the second trimester was strongly associated with a subsequent risk of preeclampsia. The potential role of second trimester inhibin A measurement in a screening strategy for preeclampsia needs to be investigated further.
Aquilina
J
J
Homerton Hospital National Health Service Trust and St Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary & Westfield College, United Kingdom.
Barnett
A
A
Thompson
O
O
Harrington
K
K
D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood*; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D015415:Biomarkers; D007265:Inhibins