Maternal serum activin A, inhibin A, and follistatin in pregnancies with appropriately grown and small-for-gestational-age fetuses classified by umbilical artery Doppler ultrasound.
OBJECTIVE
The purpose of this study was to examine the relationship of maternal serum activin A, inhibin A, and follistatin with fetal growth and placental function.


METHODS
Inhibin A, activin A, and follistatin were measured in maternal serum that was stored from normally grown (control subjects, n = 50) and small-for-gestational-age pregnancies (n = 49), prospectively classified as normal small-for-gestational-age pregnancy or fetal growth-restricted pregnancy with the use of umbilical artery Doppler ultrasound.


RESULTS
Activin A and inhibin A were significantly increased in fetal growth-restricted pregnancies compared with control subjects (activin A: regression coefficient, 0.54, P <.001; inhibin A: regression coefficient, 0.47, P =.003). The activin:follistatin ratio was significantly higher in fetal growth-restricted pregnancies compared with control subjects (P <.001). There were no significant differences between analyte levels of normal small-for-gestational-age pregnancies and control subjects.


CONCLUSIONS
Maternal serum activin A, inhibin A, and activin:follistatin ratio are raised in fetal growth-restricted pregnancies but not in normal small-for-gestational age pregnancies. This provides further evidence of the difference between subgroups within small-for-gestational-age pregnancies and emphasizes the need to stratify for this in research.
Bobrow
Catherine S
CS
Fetal Medicine Research Unit, University of Bristol, St Michael's Hospital, UK.
Holmes
Robert P
RP
Muttukrishna
Shanthi
S
Mohan
Ajitha
A
Groome
Nigel
N
Murphy
Deirdre J
DJ
Soothill
Peter W
PW
D028341:Activins / Q000097:blood*; D000328:Adult; D005260:Female; D038681:Follistatin; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D028322:Inhibin-beta Subunits / Q000097:blood*; D007265:Inhibins / Q000097:blood*; D011247:Pregnancy / Q000097:blood*; D011446:Prospective Studies; D012016:Reference Values; D018608:Ultrasonography, Doppler; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*
D038681:Follistatin; C422405:activin A; C422362:inhibin A; D028341:Activins; D007265:Inhibins; D028322:Inhibin-beta Subunits