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First‐trimester maternal serum matrix metalloproteinase‐9 (MMP‐9) and adverse pregnancy outcome
Author(s) -
Poon Leona C. Y.,
Nekrasova Ekaterina,
Anastassopoulos Panagiotis,
Livanos Panagiotis,
Nicolaides Kypros H.
Publication year - 2009
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2234
Subject(s) - preeclampsia , medicine , obstetrics , pregnancy , gestation , gestational hypertension , gestational age , matrix metalloproteinase , logistic regression , gynecology , gastroenterology , biology , genetics
Objective To investigate the potential value of maternal serum matrix metalloproteinase‐9 (MMP‐9) in first‐trimester screening for preeclampsia and spontaneous early preterm delivery. Methods The concentrations of MMP‐9, tumour necrosis factor soluble receptor‐1 (TNF‐R1), pregnancy‐associated plasma protein‐A (PAPP‐A) and uterine artery pulsatility index (UA‐PI) were measured at 11 +0 − 13 +6 weeks in cases of preeclampsia ( n = 128), gestational hypertension ( n = 88), small for gestational age ( n = 296), spontaneous early preterm delivery ( n = 57) and controls ( n = 569). The distributions of measured metabolites and UA‐PI in the control and adverse outcome groups were compared. Logistic regression analysis was used to determine the significant contributors in the prediction of adverse outcomes. Results The median MMP‐9 was higher than controls in the preeclampsia (1.190 MoM) and preterm delivery (1.187 MoM) groups. In the preeclampsia group there was a significant association between serum MMP‐9 and TNF‐R1 ( r = 0.523, P < 0.0001). Significant prediction of preeclampsia was provided by history and UA‐PI, and prediction of preterm delivery was provided by history and neither was improved by the addition of MMP‐9. Conclusion In pregnancies developing preeclampsia, the increased level of MMP‐9 and the good correlation with TNF‐R1 suggest the presence of an underlying inflammatory process. In the pregnancies resulting in spontaneous preterm delivery the small increase in MMP‐9 is not useful in the prediction of preterm delivery. Copyright © 2009 John Wiley & Sons, Ltd.