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Lambert-Messerlian G, Eklund EE, Chien EK, et al. Use of first or second trimester serum markers, or both, to predict preeclampsia. Pregnancy Hypertens. 2014;4(4):271-8doi: 10.1016/j.preghy.2014.07.001.
Lambert-Messerlian, G., Eklund, E. E., Chien, E. K., Rosene-Montella, K., Neveux, L. M., Haddow, H. R., & Palomaki, G. E. (2014). Use of first or second trimester serum markers, or both, to predict preeclampsia. Pregnancy hypertension, 4(4), 271-8. https://doi.org/10.1016/j.preghy.2014.07.001
Lambert-Messerlian, Geralyn, et al. "Use of first or second trimester serum markers, or both, to predict preeclampsia." Pregnancy hypertension vol. 4,4 (2014): 271-8. doi: https://doi.org/10.1016/j.preghy.2014.07.001
Lambert-Messerlian G, Eklund EE, Chien EK, Rosene-Montella K, Neveux LM, Haddow HR, Palomaki GE. Use of first or second trimester serum markers, or both, to predict preeclampsia. Pregnancy Hypertens. 2014 Oct;4(4):271-8. doi: 10.1016/j.preghy.2014.07.001. Epub 2014 Jul 29. PMID: 26104816.
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Pregnancy Hypertens. 2014 Oct;4(4):271-8. doi: 10.1016/j.preghy.2014.07.001. Epub 2014 Jul 29.

Use of first or second trimester serum markers, or both, to predict preeclampsia.

Pregnancy hypertension

Geralyn Lambert-Messerlian, Elizabeth E Eklund, Edward K Chien, Karen Rosene-Montella, Louis M Neveux, Hamish R M Haddow, Glenn E Palomaki

Affiliations

  1. Department of Pathology and Laboratory, Medicine Women and Infants Hospital and the Alpert Medical School at Brown University, 70 Elm Street, Providence, RI 02903, USA. Electronic address: [email protected].
  2. Department of Pathology and Laboratory, Medicine Women and Infants Hospital and the Alpert Medical School at Brown University, 70 Elm Street, Providence, RI 02903, USA. Electronic address: [email protected].
  3. Division of Maternal Fetal Medicine, MetroHealth Medical Center, Case Western Reserve University, 2500 Metrohealth Drive, Cleveland, OH 44109, USA. Electronic address: [email protected].
  4. Obstetric Medicine, Lifespan Hospitals and the Alpert Medical School at Brown University, 593 Eddy Street, Providence, RI 02905, USA. Electronic address: [email protected].
  5. Department of Pathology and Laboratory, Medicine Women and Infants Hospital and the Alpert Medical School at Brown University, 70 Elm Street, Providence, RI 02903, USA. Electronic address: [email protected].
  6. Institute of Preventive Medicine and Medical Screening, 35 Main Street, Unit 1, Windham, ME 04062, USA. Electronic address: [email protected].
  7. Department of Pathology and Laboratory, Medicine Women and Infants Hospital and the Alpert Medical School at Brown University, 70 Elm Street, Providence, RI 02903, USA. Electronic address: [email protected].

PMID: 26104816 DOI: 10.1016/j.preghy.2014.07.001

Abstract

OBJECTIVES: Preeclampsia is a serious complication of pregnancy, threatening fetal and maternal health. The aim of our study is to examine the association between preeclampsia and biochemical markers, in matched first and second trimester maternal serum samples.

STUDY DESIGN: This is a nested case/control study derived from the cohort of pregnancies delivering at Women & Infants Hospital. Cases were identified at a clinic or by hospital codes, and individually confirmed by record review. Stored samples were available from 'integrated' Down syndrome screening. Results were expressed as multiples of the median (MoM).

MAIN OUTCOME MEASURES: Preeclampsia was classified as early/severe, late/severe, or mild based on professional guidelines. An additional adverse outcome group had only gestational hypertension.

RESULTS: Ninety-eight cases were each matched with five control pregnancies. Population distribution parameters and within and between trimester correlations were derived for cases and controls for six markers, as well as in case subgroups. The strongest associations were for early/severe preeclampsia with second trimester PAPP-A (rank sum test 2.30, p<0.01); PlGF (2.60, p<0.05) inhibin A (4.45, p<0.05) and endoglin (4.25, p<0.05). No strong associations were found for sVEGF-R and FLRG. Second trimester associations were stronger than those in the first (e.g., PAPP-A 2.45, p<0.01). No between-trimester associations were found that would provide important improvements in prediction.

CONCLUSIONS: This matched analysis of the serum markers in early pregnancy allows for direct comparison of first and second trimester associations with preeclampsia. PAPP-A and PlGF are equally and highly predictive of early/severe preeclampsia.

Copyright © 2014 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

Keywords: Endoglin; Inhibin A; PAPP-A; PlGF; Preeclampsia

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