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.
Thilaganathan
Basky
B
Fetal Medicine Unit, Division of Clinical Developmental Sciences, St George's, University of London, United Kingdom. basky@pobox.com
Ralph
Elizabeth
E
Papageorghiou
Aris T
AT
Melchiorre
Karen
K
Sheldon
Joanna
J
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