PAPP-A2 and Inhibin A as Novel Predictors for Pregnancy Complications in Women With Suspected or Confirmed Preeclampsia
| Autor: | Maaike M. Alblas van der Meer, Kannan Alpadi, Langeza Saleh, Koen Verdonk, A.H. Jan Danser, Willy Visser, Rugina I. Neuman, Bhanu Kalra, Anton H. van den Meiracker, Ajay Kumar, Daan Nieboer |
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| Přispěvatelé: | Internal Medicine, Obstetrics & Gynecology, Public Health |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
sFlt‐1
Adult Placental growth factor Inhibin a medicine.medical_specialty inhibin A Gestational Age Preeclampsia preeclampsia 03 medical and health sciences 0302 clinical medicine Pre-Eclampsia PAPP‐A2 Predictive Value of Tests Pregnancy Clinical Studies medicine Humans Pregnancy-Associated Plasma Protein-A Inhibins Prospective Studies reproductive and urinary physiology Original Research 030304 developmental biology 0303 health sciences Fetus 030219 obstetrics & reproductive medicine Proteinuria business.industry Obstetrics Gestational age medicine.disease Blood pressure PlGF embryonic structures Hypertension Female Angiogenesis medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Journal of the American Heart Association, 9(19):e018219. Wiley Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 1524-4628 2047-9980 0039-2499 |
| Popis: | Background We aimed to evaluate the value of inhibin A and PAPP‐A2 (pregnancy‐associated plasma protein‐A2) as novel biomarkers in the prediction of preeclampsia‐related complications and how they compare with angiogenic biomarkers. Methods and Results Making use of a secondary analysis of a prospective, multicenter, observational study, intended to evaluate the usefulness of sFlt‐1 (soluble Fms‐like tyrosine kinase‐1)/PlGF (placental growth factor) ratio, we measured inhibin A and PAPP‐A2 levels in 524 women with suspected/confirmed preeclampsia. Women had a median gestational age of 35 weeks (range, 20–41 weeks) while preeclampsia occurred in 170 (32%) women. Levels of inhibin A and PAPP‐A2 were significantly increased in women with preeclampsia and in maternal perfusate of preeclamptic placentas. Inhibin A and PAPP‐A2 (C‐index = 0.73 and 0.75) significantly improved the prediction of maternal complications when added on top of the traditional criteria; gestational age, parity, proteinuria, and diastolic blood pressure (C‐index = 0.60). PAPP‐A2 was able to improve the C‐index from 0.75 to 0.77 when added on top of the sFlt‐1/PlGF ratio for the prediction of maternal complications. To discriminate fetal/neonatal complications on top of traditional criteria, inhibin A and PAPP‐A2 showed additive value (C‐index = 0.79 to 0.80 and 0.82, respectively) but their discriminative ability remained inferior to that of sFlt‐1/PlGF ratio or PlGF. Interestingly, the PAPP‐A2/PlGF ratio alone showed remarkable value to predict pregnancy complications, being superior to sFlt‐1/PlGF ratio in the case of maternal complications. Conclusions Inhibin A and PAPP‐A2 show significant potential to predict preeclampsia‐related pregnancy complications and might prove beneficial on top of the angiogenic markers. |
| Databáze: | OpenAIRE |
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