Maternal serum activin a at 11-13 weeks of gestation in hypertensive disorders of pregnancy.
OBJECTIVE
To investigate whether the maternal serum concentration of activin A at 11-13 weeks of gestation in pregnancies that subsequently develop hypertensive disorders is different from those with a normal outcome and to examine whether any possible differences are related to uterine artery pulsatility index (PI), serum pregnancy-associated plasma protein A (PAPP-A) and serum tumor necrosis factor-alpha receptor-1 (TNF-R1).


METHODS
Serum activin A, TNF-R1, PAPP-A and uterine artery PI were determined in a case-control study of 126 cases that developed preeclampsia, 88 that developed gestational hypertension and 214 controls.


RESULTS
In preeclampsia, compared to controls, uterine artery PI, serum activin A and serum TNF-R1 were higher and serum PAPP-A was lower. In gestational hypertension, compared to controls, serum activin A was higher but uterine artery PI, serum PAPP-A and serum TNF-R1 were not significantly different. There were no significant associations between serum activin A and either uterine artery PI or serum TNF-R1 in either the hypertensive groups or the controls.


CONCLUSIONS
The data do not support the hypothesis linking activin A with impaired trophoblastic invasion of the maternal spiral arteries, placental hypoxia and the release of cytokines which in turn cause endothelial dysfunction and the development of the clinical symptoms of the disease.
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London SE5 9RS, UK.
Ranjit
R
Akolekar
Adolfo
A
Etchegaray
Yi
Y
Zhou
Nerea
N
Maiz
Kypros H
KH
Nicolaides
D028341:Activins / Q000097:blood*; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood* / Q000175:diagnosis; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood
D047888:Receptors, Tumor Necrosis Factor, Type I; C422405:activin A; D028341:Activins