title: Ischemia-modified albumin in pregnancy.
abstract: OBJECTIVE
  In normal pregnancies, a hypoxic intrauterine environment seems necessary for early trophoblast development. In this context, maternal serum levels of ischemia-modified albumin (IMA) are elevated, reflecting the oxidative stress associated with placental development. The aim of this study was to evaluate IMA and pregnancy-associated plasma protein A (PAPP-A) in mothers bearing small-for-gestational-age (SGA) fetuses compared to normal pregnancies.
  
  
  METHODS
  A prospective study was performed between June 2010 and June 2011. Serum total albumin, IMA and PAPP-A concentrations were determined in 81 pregnant women in three different periods: 1st trimester, 2nd trimester and postpartum. Two groups of subjects were retrospectively identified: Group (1) mothers bearing appropriate-for-gestational-age (AGA) fetuses, and Group (2) mothers bearing SGA fetuses. Serum total albumin and IMA concentrations were determined in 198 non-pregnant women as controls.
  
  
  RESULTS
  Serum IMA concentrations increase during gestation. IMA/albumin serum levels in the 1st trimester were significantly higher in subjects of Group (2) (p<0.05), whereas values of serum PAPP-A MoM were significantly lower (p<0.05).
  
  
  CONCLUSIONS
  Elevated IMA serum levels together with low levels of PAPP-A were detected in the 1st trimester in mothers bearing SGA fetuses, and this may reflect early placental changes occurring before clinical manifestation of SGA.
authors.affiliation: Obstetrics and Gynecology Department, University Hospital of Udine, Udine, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Rossi
authors.forename: Nadia
authors.initials: N
authors.lastname: Bortolotti
authors.forename: Sara
authors.initials: S
authors.lastname: Vescovo
authors.forename: Irene
authors.initials: I
authors.lastname: Romanello
authors.forename: Leonardo
authors.initials: L
authors.lastname: Forzano
authors.forename: Ambrogio Pietro
authors.initials: AP
authors.lastname: Londero
authors.forename: Guido
authors.initials: G
authors.lastname: Ambrosini
authors.forename: Diego
authors.initials: D
authors.lastname: Marchesoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Curcio
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D018384:Oxidative Stress; D011247:Pregnancy / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011446:Prospective Studies; D012709:Serum Albumin; D000075462:Serum Albumin, Human
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; C561522:ischemia-modified albumin; D011266:Pregnancy-Associated Plasma Protein-A; C579283:PAPPA protein, human; D000075462:Serum Albumin, Human
keywords: Fetal growth restriction; Ischemia-modified albumin; Oxidative stress; Trophoblast development