title: Serum YKL-40 and uterine artery Doppler -- a prospective cohort study, with focus on preeclampsia and small-for-gestational-age.
abstract: OBJECTIVE
  To test if serum YKL-40 is increased in women developing preeclampsia or small-for-gestational age fetuses. We also assessed the association between uterine artery pulsatility index, notching and serum YKL-40 levels.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A primary referral unit for obstetric ultrasound.
  
  
  METHODS
  A total of 1214 unselected pregnant women enrolled at nuchal translucency examination between 11(+3) and 13(+6)  weeks of gestation.
  
  
  METHODS
  All women had ultrasound and blood sample collection at the nuchal translucency scan, a 20-week malformation scan and 25-week and 32-week fetal growth examinations. Uterine artery Doppler was assessed and outcome was registered from medical records.
  
  
  METHODS
  Preeclampsia, hypertension, small-for-gestational age.
  
  
  RESULTS
  Serum YKL-40 was associated with increasing maternal age (p < 0.0001), body mass index (p = 0.0002), primiparity (p = 0.0003), and hypertension (p = 0.015). Serum YKL-40 increased from 12 to 20 weeks and decreased from 20-25 and 25-32 weeks of gestation. No association was found between preeclampsia and serum YKL-40. Small-for-gestational-age at birth was significantly associated with a 5.4% increase in serum YKL-40 at 32 weeks of gestation (95% CI 1.5-9.3, p = 0.005). An association was found between uterine artery pulsatility index at 32 weeks and small-for-gestational age (p = 0.0015) but not between YKL-40 and uterine artery notching (p = 0.83).
  
  
  CONCLUSIONS
  Serum YKL-40 was not associated with preeclampsia. Increasing serum YKL-40 was related to maternal age, body mass index and small-for-gestational age and may reflect an exaggerated inflammatory response.
authors.affiliation: Department of Obstetrics and Gynecology, Roskilde University Hospital, Roskilde, Denmark; Molecular Unit, Department of Pathology, Copenhagen University Hospital, Herlev, Denmark.
authors.forename: Dorte
authors.initials: D
authors.lastname: Gybel-Brask
authors.forename: Estrid
authors.initials: E
authors.lastname: Høgdall
authors.forename: Julia
authors.initials: J
authors.lastname: Johansen
authors.forename: Ib Jarle
authors.initials: IJ
authors.lastname: Christensen
authors.forename: Lillian
authors.initials: L
authors.lastname: Skibsted
mesh_terms: D054392:Adipokines / Q000097:blood*; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D000071451:Chitinase-3-Like Protein 1; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D037102:Lectins / Q000097:blood*; D016014:Linear Models; D016015:Logistic Models; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011247:Pregnancy; D011446:Prospective Studies; D011673:Pulsatile Flow; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D037102:Lectins
keywords: Biomarker; YKL-40; preeclampsia; pregnancy; small-for-gestational age