First-trimester maternal serum activin A in pre-eclampsia and fetal growth restriction.
OBJECTIVE
To investigate whether the reported increase in maternal serum activin A concentration in pre-eclampsia is evident from the first trimester.


METHODS
This was a case-control study carried out in antenatal clinics among singleton pregnancies at 10-14 weeks of gestation.


METHODS
Activin A concentration was measured in stored maternal serum samples obtained at 11-14 weeks of gestation from 131 women who subsequently developed pre-eclampsia, 77 who developed non-proteinuric pregnancy-induced hypertension, 141 with fetal growth restriction in the absence of hypertensive complications and from 494 normotensive controls.


RESULTS
Compared to the median activin A level in the control group (1.00 MoM), the median MoM in the patients who subsequently developed pre-eclampsia and pregnancy-induced hypertension (1.49 MoM and 1.32 MoM, respectively) was significantly increased (p < 0.001), and in patients with fetal growth restriction (1.02 MoM) it was not significantly different (p = 0.57). In the pre-eclampsia group (n = 131) the disease was considered to be sufficiently severe to necessitate iatrogenic delivery before 35 weeks in 25 patients, and in this group the median MoM was 1.92.


CONCLUSIONS
Maternal serum activin A concentration at 12 weeks of gestation in pregnancies which subsequently develop hypertensive disease is increased, whereas in those complicated by fetal growth restriction it is normal.
Ong
C Y T
CY
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, Denmark Hill, London, UK.
Liao
A W
AW
Munim
S
S
Spencer
K
K
Nicolaides
K H
KH
D028341:Activins / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology; D006801:Humans; D028322:Inhibin-beta Subunits / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood* / Q000150:complications; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D012307:Risk Factors
C422405:activin A; D028341:Activins; D028322:Inhibin-beta Subunits