Open AccessSerum YKL ‐40 and uterine artery Doppler – a prospective cohort study, with focus on preeclampsia and small‐for‐gestational‐age
Author(s) -
GybelBrask Dorte,
Høgdall Estrid,
Johansen Julia,
Christensen Ib Jarle,
Skibsted Lillian
Publication year - 2014
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12432
Subject(s) - medicine , preeclampsia , uterine artery , obstetrics , gestational age , gestation , prospective cohort study , body mass index , gynecology , population , small for gestational age , pregnancy , genetics , environmental health , biology
Objective To test if serum YKL ‐40 is increased in women developing preeclampsia or small‐for‐gestational age fetuses. We also assessed the association between uterine artery pulsatility index, notching and serum YKL ‐40 levels. Design Prospective cohort study. Setting A primary referral unit for obstetric ultrasound. Population A total of 1214 unselected pregnant women enrolled at nuchal translucency examination between 11 +3 and 13 +6 weeks of gestation. Methods All women had ultrasound and blood sample collection at the nuchal translucency scan, a 20‐week malformation scan and 25‐week and 32‐week fetal growth examinations. Uterine artery Doppler was assessed and outcome was registered from medical records. Main outcome measures Preeclampsia, hypertension, small‐for‐gestational age. Results Serum YKL ‐40 was associated with increasing maternal age ( p < 0.0001), body mass index ( p = 0.0002), primiparity ( p = 0.0003), and hypertension ( p = 0.015). Serum YKL ‐40 increased from 12 to 20 weeks and decreased from 20–25 and 25–32 weeks of gestation. No association was found between preeclampsia and serum YKL ‐40. Small‐for‐gestational‐age at birth was significantly associated with a 5.4% increase in serum YKL ‐40 at 32 weeks of gestation (95% CI 1.5–9.3, p = 0.005). An association was found between uterine artery pulsatility index at 32 weeks and small‐for‐gestational age ( p = 0.0015) but not between YKL ‐40 and uterine artery notching ( p = 0.83). Conclusions Serum YKL ‐40 was not associated with preeclampsia. Increasing serum YKL ‐40 was related to maternal age, body mass index and small‐for‐gestational age and may reflect an exaggerated inflammatory response.