Activin A and follistatin as biomarkers for ectopic pregnancy and missed abortion.
Activin A as a predictor of pregnancy failure has been the focus of heated debate, but the value of a combined activin A and follistatin (FS) measurement in serum to predict pregnancy failure has not been reported yet. We assessed whether a single serum measurement of the two physiological antagonists at 6-8 weeks gestation could differentiate ectopic pregnancies (EP) or missed abortions (MA) from healthy intrauterine pregnancies (IUP). activin A concentrations were significantly lower in women with EP (n = 30, median value of 264 pg/mL) and women with MA (n = 30, median value of 350 pg/mL) compared to IUP (n = 33, median value of 788 pg/mL); P < 0.001. At a threshold value of 505 pg/mL, activin A had 87.9% sensitivity and 100% specificity and negative predictive value of 0.974 for discriminating an ectopic pregnancy from viable pregnancies. FS was able to discriminate IUP from EP (ROC curve P < 0.001) as was their ratio (ROC curve P = 0.008), but was unable to discriminate a MA from an EP. In EP, activin A did not correlate with beta HCG levels. The present findings support the thesis that activin A or FS could be considered promising biomarkers for the discrimination between an IUP and a failed pregnancy (MA or EP).
Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Biopolis, Larissa, Greece.
Alexandros
A
Daponte
Efthimios
E
Deligeoroglou
Antonios
A
Garas
Spyros
S
Pournaras
Christos
C
Hadjichristodoulou
Ioannis E
IE
Messinis
D000030:Abortion, Missed / Q000097:blood / Q000175:diagnosis*; D028341:Activins / Q000097:blood*; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D038681:Follistatin / Q000097:blood*; D006801:Humans; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000175:diagnosis*
D015415:Biomarkers; D038681:Follistatin; C422405:activin A; D028341:Activins