Maternal serum placental protein 13 at 11-13 weeks of gestation in preeclampsia.
OBJECTIVE
To examine the potential value of maternal serum concentration of placental protein 13 (PP13) at 11-13 weeks' gestation in screening for preeclampsia (PE).


METHODS
Serum PP13, PAPP-A and uterine artery pulsatility index (PI) were determined in a case-control study of 208 cases that developed PE including 48 that required delivery before 34 weeks (early-PE) and 416 unaffected controls.


RESULTS
Serum PP13 levels, expressed as multiples of the median (MoM) in the unaffected group, were significantly reduced in early-PE (0.83 MoM) but not in late-PE (0.96 MoM). In both early- and late-PE serum PAPP-A (0.55 and 0.84 MoM) was reduced and uterine artery PI (1.61 and 1.25 MoM) was increased. In PE pregnancies there was a significant association between serum PP13 and both uterine artery PI and serum PAPP-A (p < 0.0001 for both). Logistic regression analysis demonstrated that serum PP13 did not improve significantly the prediction of early-PE provided by a combination of maternal factors, uterine artery PI and PAPP-A.


CONCLUSIONS
PP13 is implicated in the pathogenesis of impaired placentation and subsequent development of early-PE but measurement of this placental product is unlikely to be useful in screening for the disease at 11-13 weeks.
Harris Birthright Research Centre, King's College Hospital, London SE5 9RS, UK.
Ranjit
R
Akolekar
Argyro
A
Syngelaki
Jarek
J
Beta
Rafal
R
Kocylowski
Kypros H
KH
Nicolaides
D017668:Age of Onset; D016022:Case-Control Studies; D005189:False Positive Reactions; D005260:Female; D037161:Galectins / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D009035:Mothers; D010929:Placentation / Q000502:physiology; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D011296:Prenatal Diagnosis; D012307:Risk Factors; D013997:Time Factors
D037161:Galectins; C038195:LGALS13 protein, human; D011257:Pregnancy Proteins; D011266:Pregnancy-Associated Plasma Protein-A