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Free leptin index and PAPP‐A: a first trimester maternal serum screening test for pre‐eclampsia
Author(s) -
Hedley Paula L.,
Placing Sophie,
Wøjdemann Karen,
Carlsen Anting Liu,
Shalmi AnneCathrine,
Sundberg Karin,
Tabor Ann,
Christiansen Michael
Publication year - 2010
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.2337
Subject(s) - leptin , pregnancy associated plasma protein a , medicine , eclampsia , population , gestation , gestational age , preeclampsia , pregnancy , endocrinology , obstetrics , gynecology , first trimester , biology , obesity , genetics , environmental health
Background Prophylaxis with low‐dose aspirin may reduce the risk of pre‐eclampsia (PE) if introduced in first trimester. The performance of first trimester maternal serum screening for PE using free leptin index (fLI) and PAPP‐A, where fLI = leptin/leptin soluble receptor was studied. Methods First trimester serum samples from 126 PE pregnancies and 289 control pregnancies were studied. fLI and PAPP‐A were converted into gestational age and maternal weight independent log MoM values of PAPP‐A and fLI. The screening performance of markers was studied by receiver‐operator‐characteristics curves. The performance of population screening was estimated by Monte Carlo simulation. Results fLI was significantly ( p < 0.001) elevated [mean log MoM 0.2165 (SD: 0.2604)] compared to controls [mean log MoM −0.0368 (SD: 0.3132)] and PAPP‐A was significantly ( p < 0.001) reduced [mean log MoM −0.0133 (SD: 0.2661)] compared to controls [mean log MoM 0.0474 (SD: 0.2521)] in PE pregnancies. There was no correlation between fLI and PAPP‐A in control or PE pregnancies. Combined fLI and PAPP‐A screening for PE had estimated population detection rates of 22% and 35% for false positives rates of 6% and 12%, respectively. Conclusion Combining PAPP‐A and fLI improves screening performance for PE compared to single marker screening. Copyright © 2009 John Wiley & Sons, Ltd.