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Maternal serum placental protein 13 at 11–13 weeks of gestation in preeclampsia
Author(s) -
Akolekar Ranjit,
Syngelaki Argyro,
Beta Jarek,
Kocylowski Rafal,
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.2375
Subject(s) - uterine artery , preeclampsia , gestation , placentation , medicine , obstetrics , pathogenesis , placenta , pregnancy , fetus , endocrinology , biology , genetics
Objective To examine the potential value of maternal serum concentration of placental protein 13 (PP13) at 11–13 weeks' gestation in screening for preeclampsia (PE). Methods Serum PP13, PAPP‐A and uterine artery pulsatility index (PI) were determined in a case–control study of 208 cases that developed PE including 48 that required delivery before 34 weeks (early‐PE) and 416 unaffected controls. Results Serum PP13 levels, expressed as multiples of the median (MoM) in the unaffected group, were significantly reduced in early‐PE (0.83 MoM) but not in late‐PE (0.96 MoM). In both early‐ and late‐PE serum PAPP‐A (0.55 and 0.84 MoM) was reduced and uterine artery PI (1.61 and 1.25 MoM) was increased. In PE pregnancies there was a significant association between serum PP13 and both uterine artery PI and serum PAPP‐A ( p < 0.0001 for both). Logistic regression analysis demonstrated that serum PP13 did not improve significantly the prediction of early‐PE provided by a combination of maternal factors, uterine artery PI and PAPP‐A. Conclusion PP13 is implicated in the pathogenesis of impaired placentation and subsequent development of early‐PE but measurement of this placental product is unlikely to be useful in screening for the disease at 11–13 weeks. Copyright © 2009 John Wiley & Sons, Ltd.