Maternal serum endostatin at gestational weeks 16-20 is elevated in subsequent pre-eclampsia but not in intrauterine growth retardation.
OBJECTIVE
Endostatin, an important anti-angiogenic factor produced by endothelial cells, is elevated in established pre-eclampsia. We measured maternal serum endostatin concentrations in early pregnancy associated with later pre-eclampsia and intrauterine growth retardation (IUGR).


METHODS
Retrospective case-control study.


METHODS
University Central Hospital.


METHODS
Serum samples were collected at 12-15 and 16-20 gestational weeks from a total of 124 pregnant women of whom 49 developed pre-eclampsia, 16 gave birth to infants with IUGR without pre-eclampsia, and 59 remained normotensive giving birth to healthy, normal-weight infants.


METHODS
Enzyme-linked immunosorbent assay.


METHODS
Endostatin concentrations in serum.


RESULTS
At 12-15 gestational weeks, there was no difference in median endostatin concentrations between the groups. At 16-20 gestational weeks, the median endostatin concentration was higher in the women with subsequent pre-eclampsia (p=0.026), especially preceding a later severe form of the disease (p=0.041), than in the controls. The results were further confirmed by receiver operating characteristic (ROC) analysis showing an area under the curve (AUC) of 0.64 (95% confidence interval: 0.50-0.81) for endostatin to identify subsequent pre-eclampsia, and 0.71 (0.53-0.89) in cases of severe pre-eclampsia. Optimal cut-off values were determined and used for calculations of sensitivity and specificity, which were 80 and 52% (cut-off value = 58.0 microg/L) in pre-eclampsia, and 80 and 65% (cut-off value = 65.5 microg/L) in the severe form of the disease.


CONCLUSIONS
The concentrations of endostatin in maternal serum at 16-20 weeks' of gestation are associated with an increased risk of pre-eclampsia but not IUGR.
Wathén
Katja-Anneli
KA
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Biomedicum Helsinki, Finland. katja-anneli.wathen@helsinki.fi
Ylikorkala
Olavi
O
Andersson
Sture
S
Alfthan
Henrik
H
Stenman
Ulf-Håkan
UH
Vuorela
Piia
P
D000328:Adult; D016022:Case-Control Studies; D043169:Endostatins / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood* / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000097:blood; D011262:Pregnancy Trimester, Second / Q000097:blood*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D043169:Endostatins