First trimester markers for pre-eclampsia: placental vs. non-placental protein serum levels.
OBJECTIVE
Parallel investigation, in a matched case-control study, of the association of different first-trimester markers with the risk of subsequent pre-eclampsia (PE).


METHODS
The levels of different first trimester serum markers and fetal nuchal translucency thickness were compared between 52 cases of PE and 104 control women by non-parametric two-group comparisons and by calculating matched odds ratios.


RESULTS
In univariable analysis increased concentrations of inhibin A and activin A were associated with subsequent PE (p < 0.02). Multivariable conditional logistic regression models revealed an association between increased risk of PE and increased inhibin A and translucency thickness and respectively reduced pregnancy-associated plasma protein A (PAPP-A) and placental lactogen . However, these associations varied with the gestational age at sample collection. For blood samples taken in pregnancy weeks 12 and 13 only, increased levels of activin A, inhibin A and nuchal translucency thickness, and lower levels of placenta growth factor and PAPP-A were associated with an increased risk of PE.


CONCLUSIONS
Members of the inhibin family and to some extent PAPP-A and placental growth factor are superior to other serum markers, and the predictive value of these depends on the gestational age at blood sampling. The availability of a single, early pregnancy 'miracle' serum marker for PE risk assessment seems unlikely in the near future.
Zwahlen
Marcel
M
Division of Epidemiology and Biostatistics, Department of Social and Preventive Medicine, University of Berne, Berne, Switzerland.
Gerber
Susan
S
Bersinger
Nick A
NA
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood* / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D020738:Leptin / Q000378:metabolism; D016015:Logistic Models; D048208:Nuchal Translucency Measurement; D010920:Placenta / Q000378:metabolism; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000032:analysis; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D012189:Retrospective Studies
D015415:Biomarkers; D016209:Interleukin-8; D020738:Leptin; C000608036:PGF protein, human; D011257:Pregnancy Proteins; C422362:inhibin A; D000072483:Placenta Growth Factor; D007265:Inhibins; D002097:C-Reactive Protein; D011266:Pregnancy-Associated Plasma Protein-A