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First‐trimester maternal serum tumor necrosis factor receptor‐1 and pre‐eclampsia
Author(s) -
Leal A. M.,
Poon L. C. Y.,
Frisova V.,
Veduta A.,
Nicolaides K. H.
Publication year - 2009
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.6275
Subject(s) - medicine , eclampsia , gestation , logistic regression , obstetrics , gestational age , receiver operating characteristic , percentile , pregnancy , tumor necrosis factor alpha , uterine artery , birth weight , gynecology , statistics , genetics , mathematics , biology
Objectives To examine whether the maternal serum concentration of the soluble receptor‐1 of tumor necrosis factor‐α (TNF‐R1) at 11–13 weeks of gestation in pregnancies that subsequently develop pre‐eclampsia is different from that in women without this complication. Methods The concentration of TNF‐R1 at 11 + 0 to 13 + 6 weeks was measured in samples from 128 cases that subsequently developed pre‐eclampsia and 569 controls with no pregnancy complications. TNF‐R1 and uterine artery pulsatility index (UtA‐PI) values were expressed as multiples of the median (MoM) adjusted for maternal factors. The distributions of log TNF‐R1 MoM and log UtA‐PI MoM in the control and pre‐eclampsia groups were compared. Logistic regression analysis was used to determine whether a significant contribution is provided by maternal factors, TNF‐R1 and UtA‐PI in predicting pre‐eclampsia. The performance of screening was determined by analysis of receiver–operating characteristics curves. Results Median TNF‐R1 and UtA‐PI were significantly higher in the pre‐eclampsia group (TNF‐R1, 1.062 MoM; UtA‐PI, 1.301 MoM) than in the control group (TNF‐R1, 0.996 MoM; UtA‐PI, 1.037 MoM). There was no significant association between TNF‐R1 and gestational age at delivery, birth weight percentile or UtA‐PI. Logistic regression analysis demonstrated significant contributions to the detection of pre‐eclampsia from maternal factors and UtA‐PI but not from TNF‐R1. Conclusions In pregnancies developing pre‐eclampsia the maternal serum TNF‐R1 concentration at 11–13 weeks of gestation is increased, but the level of TNF‐R1 is not associated with the degree of impairment in placental perfusion or the severity of pre‐eclampsia. Measurement of serum TNF‐R1 does not improve the prediction of pre‐eclampsia provided by screening based on a combination of maternal factors and UtA‐PI. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.