Raised maternal serum cystatin C: an early pregnancy marker for preeclampsia.
The balance between trophoblast cathepsin and decidual cystatin C expression is pivotal in physiological trophoblast development. Defective trophoblast invasion is characteristic of preeclampsia and may involve derangement of the cathepsin/cystatin C balance. We conducted a prospective nested case-control study of healthy women with singleton pregnancies in the first trimester of pregnancy. Maternal serum cystatin C concentrations in those subsequently developing preeclampsia (n = 30) were compared to controls with normal outcome (n = 90). The median cystatin C concentration in early pregnancy was significantly higher (P = .0001) in those who subsequently developed preeclampsia (median 0.65 mg/L) when compared to normal pregnancy (median 0.57 mg/L). Of the 30 women developing preeclampsia, 14 (47%) had cystatin C above the 80th centile (0.67 mg/L) for the controls. Maternal serum cystatin C concentrations in early pregnancy may be of value in identifying women at high risk of developing preeclampsia.
Fetal Medicine Unit, Division of Clinical Developmental Sciences, St George's, University of London, United Kingdom. basky@pobox.com
Basky
B
Thilaganathan
Elizabeth
E
Ralph
Aris T
AT
Papageorghiou
Karen
K
Melchiorre
Joanna
J
Sheldon
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D055316:Cystatin C / Q000378:metabolism*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D018570:Risk Assessment; D015854:Up-Regulation; D055815:Young Adult
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C