Can first trimester placental biomarkers copeptin and PP13 predict preeclampsia in advanced age nulliparous women?

Abstract

Preeclampsia (PE) affects approximately 3% of all pregnancies and it is still a major cause of adverse perinatal outcome. PE is a multisystem pregnancy related disorder of unknown aetiology with a progressive course and with no established therapy. In recent times excessive research was conducted on early screening for PE with an aim to reduce the prevalence of the disease with early medical treatment starting from the first trimester of pregnancy in the high-risk group. The aim of this study is to detect if the first trimester serum copeptin and PP13 can predict preeclampsia in advanced age nulliparous women. These are the preliminary results of an ongoing prospective study that will include 400 pregnant women undergoing first trimester aneuploidy screening at the Department for Obstetrics and Gynaecology, University Hospital Centre Zagreb. Maternal risk factors used as inclusion criteria in this study were: nulliparity and age >35. Participants were asked to complete a short questionnaire regarding personal and medical information. Blood samples were collected and maternal serum PP13 and copeptin levels were measured. Following the inclusion criteria, we analysed the records of 40 women who gave birth to this date. Three patients (7.5%) developed preeclampsia and eight (20%) had gestational hypertension (GH). All PE patients had elevated plasma copeptin. Our preliminary data suggests that early screening for PE at 11-13 weeks of gestation using biomarkers copeptin and PP-13, in combination with maternal risk factors, is by far the most promising method for early detection of PE in advanced age nulliparous women.

Maternal Serum Copeptin As a Biomarker For Intrauterine Growth Restriction

“…Another study suggested an increased maternal serum copeptin levels in pregnant women with IUGR as compared with pregnant women with AGA fetuses. So, our study supports the previous studies that maternal serum copeptin levels are raised in pregnant women with IUGR as compared to pregnant women with adequate for gestational age fetuses which can be helpful in detection of IUGR [22].…”

Placental protein 13

“…Measurement of PP13 is not a routine investigation in clinical medicine but gained much attention in pregnancyrelated research. In many studies, quantification of PP13 in biological sample was done either by ELISA [19][20][21][22][66][67][68][69][70][71][72][73][74][75][76] or by dissociation-enhanced lanthanide fluorescence immunoassay (DELFIA) methods. [77][78][79][80][81][82][83][84][85][86] The underlying principle of ELISA for the estimation of PP13 is an enzyme-linked antibody sandwich method.…”

“…Beljan et al 22 conducted a prospective study to detect whether the first trimester serum PP13 and copeptin can predict preeclampsia in advanced age nulliparous women. This study confirmed a significant contribution for the combination of two biomarkers for the prediction of preeclampsia ( p = 0.007).…”

“…However, the levels gradually increase as gestation progresses. [19][20][21][22] The exact reason for the decreased PP13 levels in first trimester and increased levels in the third trimester is not known which is in line with the etiology of the preeclampsia. Preeclampsia is associated with impaired placentation, 23,24 evidence of low serum levels of PP13, and other heterogeneous causes, hence became a major cause for morbidity and mortality of fetus and mother.…”