First-trimester maternal serum tumor necrosis factor receptor-1 and pre-eclampsia.
OBJECTIVE
To examine whether the maternal serum concentration of the soluble receptor-1 of tumor necrosis factor-alpha (TNF-R1) at 11-13 weeks of gestation in pregnancies that subsequently develop pre-eclampsia is different from that in women without this complication.


METHODS
The concentration of TNF-R1 at 11 + 0 to 13 + 6 weeks was measured in samples from 128 cases that subsequently developed pre-eclampsia and 569 controls with no pregnancy complications. TNF-R1 and uterine artery pulsatility index (UtA-PI) values were expressed as multiples of the median (MoM) adjusted for maternal factors. The distributions of log TNF-R1 MoM and log UtA-PI MoM in the control and pre-eclampsia groups were compared. Logistic regression analysis was used to determine whether a significant contribution is provided by maternal factors, TNF-R1 and UtA-PI in predicting pre-eclampsia. The performance of screening was determined by analysis of receiver-operating characteristics curves.


RESULTS
Median TNF-R1 and UtA-PI were significantly higher in the pre-eclampsia group (TNF-R1, 1.062 MoM; UtA-PI, 1.301 MoM) than in the control group (TNF-R1, 0.996 MoM; UtA-PI, 1.037 MoM). There was no significant association between TNF-R1 and gestational age at delivery, birth weight percentile or UtA-PI. Logistic regression analysis demonstrated significant contributions to the detection of pre-eclampsia from maternal factors and UtA-PI but not from TNF-R1.


CONCLUSIONS
In pregnancies developing pre-eclampsia the maternal serum TNF-R1 concentration at 11-13 weeks of gestation is increased, but the level of TNF-R1 is not associated with the degree of impairment in placental perfusion or the severity of pre-eclampsia. Measurement of serum TNF-R1 does not improve the prediction of pre-eclampsia provided by screening based on a combination of maternal factors and UtA-PI.
Leal
A M
AM
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
Poon
L C Y
LC
Frisova
V
V
Veduta
A
A
Nicolaides
K H
KH
D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011673:Pulsatile Flow; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood*; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply; D055815:Young Adult
D015415:Biomarkers; D047888:Receptors, Tumor Necrosis Factor, Type I