title: Maternal serum activin A and the prediction of intrauterine growth restriction.
abstract: BACKGROUND
  Differentiating between the small healthy fetus and the high risk growth restricted fetus remains a significant obstetric challenge. It has been previously shown that maternal activin A levels are increased in association with fetal growth restriction.
  
  
  OBJECTIVE
  To evaluate maternal serum activin A as a marker of fetal growth restriction.
  
  
  METHODS
  Prospective cohort study of 62 women referred for fetal assessment because of a clinical suspicion of a small for gestation fetus. Maternal serum levels of activin A were measured with an ELISA.
  
  
  RESULTS
  Activin A levels, expressed as median (95% CI) MoMs, were similar in the women with a normal-sized fetus and in those with a healthy small for gestational age fetus, 1.14 (95% CI 1.0-1.5) and 1.31 (95% CI 0.8-2.1), respectively (P = 0.97). Compared to the women with a normal-sized fetus or a healthy small fetus, activin A levels were significantly elevated in the women who had an intrauterine fetal growth restriction fetus 2.37 (95% CI 1.6-3.7; P = 0.01 compared to normal and P = 0.04 compared to healthy small).
  
  
  CONCLUSIONS
  These data confirm that circulating activin A is increased in association with fetal growth restriction. However, a single blood sample for activin A will not efficiently discern between healthy and compromised small fetuses.
authors.affiliation: Maternal-Fetal Medicine Unit, Monash Medical Centre, Victoria, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Barkehall-Thomas
authors.forename: Stephen
authors.initials: S
authors.lastname: Tong
authors.forename: Lesleigh S
authors.initials: LS
authors.lastname: Baker
authors.forename: Andrew
authors.initials: A
authors.lastname: Edwards
authors.forename: Euan M
authors.initials: EM
authors.lastname: Wallace
mesh_terms: D028341:Activins / Q000032:analysis / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D005865:Gestational Age; D006801:Humans; D028322:Inhibin-beta Subunits / Q000032:analysis / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D011296:Prenatal Diagnosis / Q000379:methods*; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; C422405:activin A; D028341:Activins; D028322:Inhibin-beta Subunits