title: Umbilical cord serum activin A levels are increased in pre-eclampsia with impaired blood flow in the uteroplacental and fetal circulation.
abstract: The aims of the present study were to evaluate the umbilical cord serum activin A concentrations in complicated pregnancies and also to explore the relationship between activin A levels and blood flow velocity in fetal arteries. Umbilical cord blood samples were obtained postpartum after a full term uneventful gestation (control group, n=40), and from pregnancies complicated by gestational diabetes (n=13), preterm labour (n=18), or pre-eclampsia (n=19). Cord serum activin A levels were three-fold higher in pregnancies complicated by pre-eclampsia (1.17+/-0.14 ng/ml, p<0.01) than in the control group (0.43+/-0.03 ng/ml), but were unaltered in the diabetes and preterm labour groups. The pre-eclampsia group had a marked increase of umbilical artery pulsatility index (PI) and also a decrease of middle cerebral artery PI (p<0.01). Furthermore, activin A concentration correlated directly with the umbilical artery PI (r=0.540, p=0.021), with the length of stay in the Neonatal Intensive Care Unit (r=0.857, p<0.001) and also with cord blood pH (r=-0.886, p<0.001). In conclusion, umbilical cord serum activin A levels are increased in the presence of pre-eclampsia and provide an indirect marker of impaired blood flow in the uteroplacental and fetal circulation.
authors.affiliation: Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Policlinico Le Scotte, Viale Bracci, 53100 Siena, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Florio
authors.forename: F M
authors.initials: FM
authors.lastname: Reis
authors.forename: F M
authors.initials: FM
authors.lastname: Severi
authors.forename: S
authors.initials: S
authors.lastname: Luisi
authors.forename: A
authors.initials: A
authors.lastname: Imperatore
authors.forename: M A
authors.initials: MA
authors.lastname: Palumbo
authors.forename: F
authors.initials: F
authors.lastname: Bagnoli
authors.forename: W
authors.initials: W
authors.lastname: Gioffre
authors.forename: F
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D028341:Activins / Q000097:blood*; D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000097:blood / Q000503:physiopathology; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D028322:Inhibin-beta Subunits / Q000097:blood*; D020768:Middle Cerebral Artery / Q000503:physiopathology; D007752:Obstetric Labor, Premature / Q000097:blood / Q000503:physiopathology; D021041:Placental Circulation / Q000502:physiology*; D011225:Pre-Eclampsia / Q000097:blood* / Q000503:physiopathology; D011247:Pregnancy; D014469:Umbilical Arteries / Q000503:physiopathology
chemical_list: C422405:activin A; D028341:Activins; D028322:Inhibin-beta Subunits