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Acute-phase proteins in prediction of preeclampsia in patients with abnormal midtrimester uterine Doppler velocimetry

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Aims

Manifestation of preeclampsia is characterized by an inflammatory response and altered expression of acute-phase proteins. In this study, we examined the predictive value of serum amyloid A, progranulin, transthyretin, C-reactive protein and interleukin-6. Soluble endoglin was used as control.

Methods

Maternal serum levels of the putative biomarkers were measured in 49 women with a midtrimester bilateral abnormal uterine artery Doppler velocimetry.

Results

Preeclampsia developed in 26.5 %. 75.0 % had an early-onset disease (<34 + 0 weeks). Delivery <34 + 0 weeks was indicated in 16.3 %. 12.2 % of patients developed a normotensive intrauterine growth restriction. All of the putative biomarkers were not predictive for preeclampsia. But serum levels of progranulin and also of soluble endoglin were increased in cases with development of a severe normotensive intrauterine growth restriction. Only soluble endoglin was predictive for the development of preeclampsia with an area under curve in the receiver operating curve analysis of 0.761 (P = 0.006). Using a cut-off level of ≥9.14 ng/mL, sensitivity, specificity, positive predictive value and negative predictive value were 53.9, 88.9, 63.6 and 84.2 %, respectively.

Conclusions

Inflammation is a late event during development of preeclampsia, and acute-phase proteins are not predictive for the disease in a high-risk population without clinical symptoms during the second trimester. Progranulin is a putative new biomarker for an early detection of intrauterine growth restriction in women without concomitant hypertensive disorders. Soluble endoglin improved predictive values for preeclampsia in patients with abnormal uterine Doppler.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Rostock, Suedring 81, 18059, Rostock, Germany

    Johannes Stubert, Michael Bolz, Max Dieterich, Dagmar-Ulrike Richter & Toralf Reimer

  2. Department of Vascular Surgery, Hospital Suedstadt Rostock, Suedring 81, 18059, Rostock, Germany

    Torsten Kleber

  3. Centre of prenatal diagnosis “Praxiszentrum Frauenheilkunde”, Suedring 81, 18059, Rostock, Germany

    Thomas Külz

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  1. Johannes Stubert
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  2. Torsten Kleber
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  4. Thomas Külz
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  6. Dagmar-Ulrike Richter
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Corresponding author

Correspondence to Johannes Stubert.

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Funding

The study was financed by own resources.

Conflict of interest

Author J Stubert declares that he has no conflict of interest. Author T Kleber declares that he has no conflict of interest. Author M Bolz declares that he has no conflict of interest. Author T Külz declares that he has no conflict of interest. Author M Dieterich declares that he has no conflict of interest. Author DU Richter declares that she has no conflict of interest. Author T Reimer declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committee (IRB Project No. A2010100).

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Informed consent was obtained from all individual participants included in the study.

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Stubert, J., Kleber, T., Bolz, M. et al. Acute-phase proteins in prediction of preeclampsia in patients with abnormal midtrimester uterine Doppler velocimetry. Arch Gynecol Obstet 294, 1151–1160 (2016). https://doi.org/10.1007/s00404-016-4138-2

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