First-trimester placental protein 13 screening for preeclampsia and intrauterine growth restriction.
OBJECTIVE
The purpose of this study was to evaluate first-trimester serum placental protein 13 (PP13) as a screening test for preeclampsia and intrauterine growth restriction (IUGR).


METHODS
We performed a prospective, nested case-control study in the Massachusetts General Hospital Obstetric Maternal Study. PP13 was measured by solid-phase sandwich enzyme-linked immunosorbent assay in serum samples that were collected at the first prenatal visit (9-12 weeks of gestation) from women who subsequently experienced preeclampsia (n = 47), IUGR (n = 42), or preterm delivery (n = 46). Women with uncomplicated term deliveries served as control subjects (n = 290) and were matched to cases by gestational age when serum was collected and for the duration of specimen storage.


RESULTS
The median first-trimester PP13 level was 132.5 pg/mL in the control subjects. Median PP13 levels were significantly lower among women who had preeclampsia (27.2 pg/mL; P < .001), IUGR (86.6 pg/mL; P < .001), and preterm delivery (84.9 pg/mL; P = .007). When PP13 was expressed as multiples of the gestational age-specific medians among the control subjects, the multiples of the medians were 0.2 for preeclampsia, 0.6 for IUGR, and 0.6 for preterm delivery (P < .001 for each disorder compared with control subjects). Receiver operating characteristic analysis yielded areas under the curve of 0.91, 0.65, and 0.60 for preeclampsia, IUGR, and preterm delivery, respectively. At a 90% specificity rate, the corresponding sensitivities were 79%, 33%, and 28%, respectively.


CONCLUSIONS
The screening of maternal PP13 levels in the first trimester is a promising diagnostic tool for the prediction of preeclampsia with high sensitivity and specificity.
Chafetz
Ilana
I
Diagnostic Technologies Ltd, Haifa, Israel.
Kuhnreich
Ido
I
Sammar
Marei
M
Tal
Yossi
Y
Gibor
Yair
Y
Meiri
Hamutal
H
Cuckle
Howard
H
Wolf
Myles
M
D000328:Adult; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000175:diagnosis*; D037161:Galectins / Q000096:biosynthesis / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D007752:Obstetric Labor, Premature; D010920:Placenta / Q000378:metabolism; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000096:biosynthesis / Q000097:blood*; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D037161:Galectins; C038195:LGALS13 protein, human; D011257:Pregnancy Proteins