title: TNF-R1 as a first trimester marker for prediction of pre-eclampsia.
abstract: OBJECTIVE
  To examine whether the maternal serum concentration of the soluble receptor-1 of tumor necrosis factor-α (TNF-R1) at 11-13 + 6 weeks of gestation is a predictor of development of pre-eclampsia (PE).
  
  
  METHODS
  This is a nested case-control study in which the concentration of TNF-R1 at 11 + 0 to 13 + 6 weeks was measured in 426 pregnant women in the first trimester. TNF-R1 values were expressed as multiples of the median (MoM) adjusted for maternal factors. The distributions of log TNF-R1 MoM in the control group and hypertensive disorders (early-PE [ePE], late-PE [lPE] and gestational hypertension [GH]) groups were compared. Logistic regression analysis was used to determine whether maternal factors, TNF-R1 or their combination make a significant contribution to the prediction of PE. Screening performance was determined by analysis of receiver-operating characteristics curves.
  
  
  RESULTS
  Median concentration of TNF-R1 (ng/ml) was higher in ePE (2.62 ± 0.67), lPE (2.12 ± 0.56) and GH (2.19 ± 0.45) compared to controls (2.04 ± 0.42), p = 0.001. Logistic regression analysis demonstrated that the addition of TNFR-1 to maternal factors did not make a significant contribution to the prediction of PE.
  
  
  CONCLUSIONS
  The maternal serum TNF-R1 concentration at 11-13 + 6 weeks of gestation was increased in pregnancies which developed hypertensive disorders, however, the addition of TNFR-1 did not improve the detection rate of these conditions compared with maternal factors alone.
authors.affiliation: a School of Medicine, University of Fortaleza (UNIFOR) , Ceará , Brazil .|b Department of Public Health , State University of Ceará , Fortaleza , Ceará , Brazil .|c Department of Perinatal Medicine , Royal Women's Hospital , Melbourne , Victoria , Australia .
authors.forename: Sammya Bezerra Maia
authors.initials: SB
authors.lastname: E Holanda Moura
authors.affiliation: d Central Clinical School, University of Sydney , Sydney , New South Wales , Australia .
authors.forename: Felicity
authors.initials: F
authors.lastname: Park
authors.affiliation: e Northwest Academic Centre, University of Melbourne , Victoria , Australia .
authors.forename: Padma
authors.initials: P
authors.lastname: Murthi
authors.affiliation: f Department of Obstetrics and Gynecology , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , São Paulo , Brazil .
authors.forename: Wellington P
authors.initials: WP
authors.lastname: Martins
authors.affiliation: c Department of Perinatal Medicine , Royal Women's Hospital , Melbourne , Victoria , Australia .|g Department of Obstetrics and Gynaecology , University of Melbourne , Victoria , Australia .
authors.forename: Stefan C
authors.initials: SC
authors.lastname: Kane
authors.affiliation: d Central Clinical School, University of Sydney , Sydney , New South Wales , Australia .
authors.forename: Paul
authors.initials: P
authors.lastname: Williams
authors.affiliation: d Central Clinical School, University of Sydney , Sydney , New South Wales , Australia .|h RPA Women and Babies, Royal Prince Alfred Hospital , Sydney , New South Wales , Australia , and.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hyett
authors.affiliation: c Department of Perinatal Medicine , Royal Women's Hospital , Melbourne , Victoria , Australia .|g Department of Obstetrics and Gynaecology , University of Melbourne , Victoria , Australia .|i Monash Ultrasound for Women , Melbourne , Victoria , Australia.
authors.forename: Fabrício
authors.initials: F
authors.lastname: da Silva Costa
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D047888:Receptors, Tumor Necrosis Factor, Type I
keywords: Biomarkers; hypertension; obstetrics; pregnancy; pregnancy-induced; screening