title: First trimester serum placental growth factor and hyperglycosylated human chorionic gonadotropin are associated with pre-eclampsia: a case control study.
abstract: To study whether maternal serum hyperglycosylated human chorionic gonadotropin (hCG-h) improves first trimester prediction of pre-eclampsia when combined with placental growth factor (PlGF), pregnancy-associated plasma protein-A (PAPP-A) and maternal risk factors.
  
  
  
  Gestational-age-adjusted concentrations of hCG, hCG-h, PlGF and PAPP-A were analysed in serum samples by time-resolved immunofluorometric assays at 8-13 weeks of gestation. The case-control study included 98 women who developed pre-eclampsia, 25 who developed gestational hypertension, 41 normotensive women with small-for-gestational-age (SGA) infants and 177 controls.
  
  
  
  Of 98 women with pre-eclampsia, 24 women developed preterm pre-eclampsia (diagnosis < 37 weeks of gestation) and 13 of them had early-onset pre-eclampsia (diagnosis < 34 weeks of gestation). They had lower concentrations of PlGF, PAPP-A and proportion of hCG-h to hCG (%hCG-h) than controls. In receiver-operating characteristics (ROC) curve analysis, the area under the curve (AUC) for the combination of PlGF, PAPP-A, %hCG-h, nulliparity and mean arterial blood pressure was 0.805 (95% confidence interval, CI, 0.699-0.912) for preterm pre-eclampsia and 0.870 (95% CI 0.750-0.988) for early-onset pre-eclampsia. Without %hCG-h the AUC values were 0.756 (95% CI 0.651-0.861) and 0.810 (95% CI 0.682-0.938) respectively. For prediction of gestational hypertension, the AUC for %hCG-h was 0.708 (95% CI 0.608-0.808), but for other markers the AUC values were not significant. None of the AUC values were significant for the prediction of SGA infants in normotensive women.
  
  
  
  First trimester maternal serum %hCG-h tended to improve prediction of preterm and early-onset pre-eclampsia when combined with PlGF, PAPP-A and maternal risk factors.
authors.affiliation: Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Northern Ostrobothnia Hospital District, PB 23, 90029, Oulu, Finland.
authors.forename: Elina
authors.initials: E
authors.lastname: Keikkala
authors.affiliation: Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Biomedicum Helsinki, PB 700, 00029, Helsinki, Finland. sini.k.koskinen@helsinki.fi.
authors.forename: Sini
authors.identifier: 0000-0001-5337-3319
authors.initials: S
authors.lastname: Koskinen
authors.affiliation: Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Biomedicum Helsinki, PB 700, 00029, Helsinki, Finland.|Obstetrics and Gynecology, Porvoo Hospital, PB 500, 06151, Porvoo, Finland.
authors.forename: Piia
authors.initials: P
authors.lastname: Vuorela
authors.affiliation: Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Biomedicum Helsinki, PB 700, 00029, Helsinki, Finland.|Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, PB 63, 00014, Helsinki, Finland.|Institute for Molecular Medicine Finland, University of Helsinki, PB 20, 00014, Helsinki, Finland.
authors.forename: Hannele
authors.initials: H
authors.lastname: Laivuori
authors.affiliation: Eastern Finland Laboratory Centre, PB 1700, 70211, Kuopio, Finland.
authors.forename: Jarkko
authors.initials: J
authors.lastname: Romppanen
authors.affiliation: Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Biomedicum Helsinki, PB 700, 00029, Helsinki, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Heinonen
authors.affiliation: Clinical Chemistry, University of Helsinki and Helsinki University Hospital, PB 700, 00029, Helsinki, Finland.
authors.forename: Ulf-Håkan
authors.initials: UH
authors.lastname: Stenman
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D000072483:Placenta Growth Factor / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012372:ROC Curve
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; D000072483:Placenta Growth Factor; D011266:Pregnancy-Associated Plasma Protein-A
keywords: Gestational hypertension; Hyperglycosylated human chorionic gonadotropin; Placental growth factor; Pre-eclampsia; Pregnancy-associated plasma protein-A; Small-for-gestational-age