First trimester levels of inhibins and activin A in normal and failing pregnancies.
OBJECTIVE
Miscarriage is the commonest complication of human pregnancy. We undertook this study to assess whether inhibin A, pro-alphaC inhibin and/or activin A, products of the corpus luteum and placenta, might be useful in either the prediction or diagnosis of miscarriage.


METHODS
Case-control study.


METHODS
Ninety-eight asymptomatic women at 6-13 weeks gestation who subsequently had a miscarriage and 198 gestation-matched women with a normal singleton pregnancy.


METHODS
Maternal serum levels of inhibin A, pro-alphaC inhibin, activin A and human chorionic gonadotrophin (hCG) were measured.


RESULTS
Inhibin A, pro-alphaC and hCG, expressed as multiples of the normal median (MoM; +/-95% confidence intervals) in the miscarriage cases were significantly lower than in the viable controls, 0.56 (0.48-0.69) MoM vs. 1.00 (0.98-1.13) MoM, 0.55 (0.51-0.84) MoM vs. 1.0 (0.86-1.22) MoM and 0.34 (0.23-0.36) MoM vs. 1.00 (0.94-1.08) MoM, respectively (P < 0.0001 for all). Of the three analytes, hCG was the most discriminating between cases and controls. Levels of activin A in the miscarriage cases were not significantly different from controls, 0.96 (0.86-1.07) vs. 1.0 (0.95-1.08).


CONCLUSIONS
These data suggest that inhibin A, pro-alphaC inhibin and activin A will not be useful in either the prediction or diagnosis of early pregnancy miscarriage.
Wallace
Euan M
EM
Centre for Women's Health Research, Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, Clayton, Victoria, Australia. euan.wallace@med.monash.edu.au
Marjono
Budi
B
Tyzack
Katrina
K
Tong
Stephen
S
D000022:Abortion, Spontaneous / Q000097:blood*; D028341:Activins / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D028322:Inhibin-beta Subunits / Q000097:blood*; D007265:Inhibins / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011498:Protein Precursors / Q000097:blood
D015415:Biomarkers; D006063:Chorionic Gonadotropin; D011498:Protein Precursors; C422405:activin A; C095971:inhibin-alpha subunit precursor; D028341:Activins; D007265:Inhibins; D028322:Inhibin-beta Subunits