Maternal serum disintegrin and metalloprotease protein-12 in early pregnancy as a potential marker of adverse pregnancy outcomes.
OBJECTIVE
The aim of this study was to determine whether the concentration of disintegrin and metalloprotease protein12 (ADAM12) in first trimester maternal serum can be used as a marker for first-trimester complete spontaneous abortions, missed abortions, ectopic pregnancies and hydatidiform moles.


METHODS
The maternal serum concentrations of ADAM12 were measured in the range of 5-9+6 weeks of gestation using an automated AutoDelfia immunoassay platform in 9 cases of complete spontaneous abortion, 27 cases of missed abortions, 56 cases of ectopic pregnancies, 12 cases of hydatidiform moles, and 100 controls. Logistic regression analysis was used to determine significant factors for predicting adverse pregnancy outcomes in early pregnancy. Screening performance was assessed using receiver operating characteristic curves.


RESULTS
Two hundred and four women were enrolled in the study. In the control group, the level of ADAM12 increased with gestational age. The median ADAM12 levels in the spontaneous abortion (0.430 MoM), ectopic pregnancy (0.460 MoM) and hydatidiform mole (0.037 MoM) groups were lower than that in the control group, while the median ADAM12 level in the missed abortion group (1.062 MoM) was not significant from the controls (1.002 MoM). Logistic regression analysis demonstrated that the level of ADAM12 in maternal serum facilitated the detection of ectopic pregnancies (OR = 0.909; 95% CI = 0.841 ∼ 0.982) and complete spontaneous abortion (OR = 0.863; 95% CI = 0.787 ∼ 0.946).


CONCLUSIONS
In complete spontaneous abortion and ectopic pregnancy, ADAM12 maintained at low levels in early pregnancies, and there were significant differences compared to normal pregnancies. ADAM12 is a promising marker for the diagnosis of complete spontaneous abortion and ectopic pregnancy in symptomatic women, and under certain conditions, ADAM12 can diagnose ectopic pregnancy and spontaneous abortion before an ultrasonographic detection of the conditions.
Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China; Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
Jiexia
J
Yang
Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China; Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
Jing
J
Wu
Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China; Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
Fangfang
F
Guo
Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China; Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
Dongmei
D
Wang
Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China; Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
Keyi
K
Chen
Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China; Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
Jie
J
Li
Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China; Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
Li
L
Du
Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China; Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China.
Aihua
A
Yin
D051722:ADAM Proteins / Q000097:blood*; D000072199:ADAM12 Protein; D000022:Abortion, Spontaneous / Q000097:blood / Q000175:diagnosis; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D006828:Hydatidiform Mole / Q000097:blood / Q000175:diagnosis; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D012372:ROC Curve; D012044:Regression Analysis; D055815:Young Adult
D015415:Biomarkers; D008565:Membrane Proteins; D051722:ADAM Proteins; D000072199:ADAM12 Protein; C000606480:ADAM12 protein, human