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First-Trimester Maternal Serum Levels of sFLT1, PGF and ADMA Predict Preeclampsia.

AbstractBACKGROUND:
Placental growth factor (PGF), soluble fms-like tyrosine kinase 1 (sFLT1) and asymmetric dimethylarginine (ADMA) are involved in the pathogenesis of preeclampsia. Abnormal maternal sFLT1, PGF and ADMA levels are detectable weeks before the onset of preeclampsia.
OBJECTIVE:
To investigate sFLT1, PGF and ADMA in the first trimester of pregnancy as predictors of preeclampsia.
METHODS:
In this prospective nested case-control study, 740 pregnant women enrolled at 12-16 weeks of gestation and followed up until 6 weeks after delivery at the Shanghai First Maternity and Infant Health Hospital of Tongji University between January 2010 and December 2012. Forty-four women developed preeclampsia. Urinary proteins were measured using 24-hour collection or dipsticks. sFLT1, PGF and ADMA were measured by ELISA in the first trimester. Pulsatility index (PI) was measured by Doppler ultrasound in the second trimester.
RESULTS:
First-trimester serum sFLT1 and ADMA levels of women who developed preeclampsia were significantly higher compared with women with normal pregnancies (sFLT1: 0.321 ± 0.023 vs. 0.308 ± 0.019 ng/ml, P = 0.001; ADMA: 0.86 ± 0.16 vs. 0.68 ± 0.20 μM, P < 0.001). First-trimester serum PGF levels of women who developed preeclampsia were significantly lower than in women with normal pregnancies (115.72 ± 32.55 vs. 217.30 ± 74.48 pg/ml, P < 0.001). Multiple logistic regression and receiver-operating characteristic curves identified first-trimester PGF and ADMA to be sensitive and selective predictors of preeclampsia (area under the curve [AUC]: 0.902), as well as second-trimester uterine artery pulse index (AUC: 0.836).
CONCLUSION:
In the first trimester, maternal serum sFLT1, PGF and ADMA levels, as well as second-trimester uterine artery PI, could predict preeclampsia.
AuthorsZheng Bian, Chenzi Shixia, Tao Duan
JournalPloS one (PLoS One) Vol. 10 Issue 4 Pg. e0124684 ( 2015) ISSN: 1932-6203 [Electronic] United States
PMID25906026 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • PGF protein, human
  • Pregnancy Proteins
  • Placenta Growth Factor
  • N,N-dimethylarginine
  • Arginine
  • FLT1 protein, human
  • Vascular Endothelial Growth Factor Receptor-1
Topics
  • Adult
  • Area Under Curve
  • Arginine (analogs & derivatives, blood)
  • Blood Pressure (physiology)
  • Case-Control Studies
  • Demography
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Placenta Growth Factor
  • Pre-Eclampsia (blood, diagnosis, diagnostic imaging)
  • Pregnancy
  • Pregnancy Proteins (blood)
  • Pregnancy Trimester, First
  • Pregnancy Trimester, Second
  • Prospective Studies
  • ROC Curve
  • Ultrasonography
  • Uterine Artery (physiology)
  • Vascular Endothelial Growth Factor Receptor-1 (blood)

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