Early onset preeclampsia and second trimester serum markers.
OBJECTIVE
To examine serum markers measured in the second trimester to identify women who subsequently develop preeclampsia.


METHODS
Clinically defined preeclampsia was confirmed in 45 women who had provided a serum sample as part of Down syndrome screening. Preeclampsia was categorized as mild or severe, as well as early (<32 weeks) or late onset. Each case was matched with five controls based on gestational age and date of serum collection. Stored sera were retrieved and tested for inhibin A, soluble vascular endothelial growth factor receptor 1 (sVEGF R1), placental growth factor (PlGF), and endoglin. Results were converted to multiples of the median (MoM) and compared in case and control pregnancies. Univariate analysis was used to identify the strongest markers, which were then used in a multivariate model.


RESULTS
Inhibin A, PlGF, and endoglin were consistently associated with preeclampsia, especially for early onset disease. A multivariate model using the three markers could identify 50% of the pregnancies with early onset preeclampsia with a 2% false positive rate.


CONCLUSIONS
The levels of inhibin A, PlGF, and endoglin in the second trimester can be combined using a predictive model to provide individualized risk estimates for early onset preeclampsia.
Lambert-Messerlian
Geralyn M
GM
Division of Medical Screening and Special Testing, Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA. gmesserl@wihri.org
Palomaki
Glenn E
GE
Neveux
Louis M
LM
Chien
Edward
E
Friedman
Alex
A
Rosene-Montella
Karen
K
Hayes
Meghan
M
Canick
Jacob A
JA
D000328:Adult; D017668:Age of Onset; D015415:Biomarkers / Q000032:analysis / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D008565:Membrane Proteins / Q000097:blood; D015233:Models, Statistical; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood*; D011379:Prognosis; D013997:Time Factors; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood; D055815:Young Adult
D015415:Biomarkers; D008565:Membrane Proteins; C098069:PIGF protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1