Development of an assay for a biomarker of pregnancy and early fetal loss.

Canfield, Robert E.; O’Connor, John F.; Birken, Steven; Krichevsky, Alexander; Wilcox, Allen J.

doi:10.1289/ehp.877457

Cited by 46 publications

(16 citation statements)

References 53 publications

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“…Urine samples were assayed for hCG using an extremely sensitive immunoradiometric assay (Can®eld et al, 1987). The sensitivity of this assay was suf®cient to provide an estimate of the day of implantation.…”

Section: Methodsmentioning

confidence: 99%

Vaginal Bleeding in Very Early Pregnancy

Harville¹,

Wilcox²,

Bird³

et al. 2004

Obstetrical & Gynecological Survey

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Although heavy alcohol use over an extended time is known to impair fetal growth, the effects, if any, of light or moderate consumption are not clear. This study examined drinking patterns on term small-for-gestational-age (SGA) births, with particular attention to binge drinking in the 3 months before pregnancy and the last 3 months of pregnancy. Data on 50,461 women who delivered singleton full-term infants (37-42 weeks gestation) were obtained from the Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Questionnaires were mailed 2 to 6 months after delivery, and nonrespondents were interviewed by phone. The study population was predominantly white, 18 to 34 years of age, had 12 or more years of education, was married, and did not smoke in late pregnancy. Light drinkers took 3 or fewer drinks in an average week, whereas moderate consumption was defined as 4 to 13 drinks and heavy drinking as 14 or more drinks per week on average. Binging was defined as taking 5 or more drinks in one sitting. Close to half the women reported drinking just before pregnancy, 94% of them at a light level. In the last trimester, fewer than 1% of all women and 18% of heavy drinkers binged. SGA births were more common in moderate or heavy prepregnancy drinkers than in light drinkers or nondrinkers. No such association was evident, however, for drinking in the last trimester. Although women who binged at either time were not significantly likelier to deliver an SGA infant, those binging in late pregnancy were 20% more likely to do so. After adjusting for confounding variables, women who were light or moderate drinkers before pregnancy were somewhat less likely to deliver an SGA infant, although the difference was not significant. Women who drank lightly or moderately in late pregnancy were not prone to have an SGA birth. At all levels of alcohol use the risk of an SGA birth was greater for bingers, but this was significant only for heavy drinkers. The lower risk of SGA birth found in some women who drink might be related to vascular effects of alcohol, or to dietary differences between women who drink before pregnancy or in late pregnancy and those who do not. A prospective study would clarify the observations made in this population of parturients. ABSTRACTVaginal bleeding in early pregnancy could be mistaken for menstruation, and it could lead to errors in estimating gestational age, especially in pregnancies that end in miscarriage. This prospective study examined patterns of vaginal bleeding in 151 healthy women whose pregnancies lasted at least 6 weeks beyond the last menstrual period (LMP). The participants collected daily urine samples that were assayed for human chorionic gonadotropin and kept a diary of vaginal bleeding as well as sexual intercourse. Early vaginal bleeding was defined as bleeding lasting a day or longer between conception and follow up, which extended through week 8 after the LMP in nearly all cases. Early vaginal bleeding was described by 9% of women. Typically, it was light and required only 1 or 2 ...

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Section: Methodsmentioning

confidence: 99%

Vaginal Bleeding in Very Early Pregnancy

Harville¹,

Wilcox²,

Bird³

et al. 2004

Obstetrical & Gynecological Survey

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“…The detection of minute quantities of hCG in the presence of human LH has allowed studies of early fetal loss (8,9), while the finding of a fragment of the hCG0 in urine (26-29) has found applications in cancer detec- …”

Section: Discussionmentioning

confidence: 99%

High Resolution High Performance Liquid Chromatography Fingerprinting of Purified Human Chorionic Gonadotropin Demonstrates that Oxidation Is a Cause of Hormone Heterogeneity*

Pollak

Halpine²,

Chait³

et al. 1990

Endocrinology

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To characterize the structures of the various forms of hCG and its immunologically related fragments measured in blood, urine, and tissue culture media, we developed a highly sensitive HPLC tryptic fingerprinting system that can characterize as little as 15 micrograms of material. Standard preparations of the subunits of hCG purified from pregnancy urine were found to exhibit heterogeneity on reverse phase HPLC chromatography, complicating efforts to characterize such forms of hCG. The same type of chromatographic heterogeneity was observed when the hormone was reduced and S-carboxymethylated (RCM) and its RCM subunits separated on HPLC. One major and one minor peak were observed in the alpha- and beta-subunits from both native and RCM hormone, with a ratio of between 5:1 and 10:1. Development and application of a high resolution, semimicrobore HPLC fingerprint technique used together with an examination of selected peptides by amino acid sequencing and mass spectrometry defined the differences between these forms as oxidation. Using each of the isolated RCM subunit's major and minor HPLC peaks, the oxidation was shown to be reversible and probably due to interconversion of methionine with its sulfoxide form.

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“…[9] We employed a highly-sensitive immunoradiometric assay to quantify hCG in the urine samples. [10] Pregnancy was defined as a rise in hCG that exceeded 0.025ng/ml for three consecutive days. [3] A pregnancy was categorized as an early loss if the initial rise in hCG was followed by a decline to baseline with menstrual-like bleeding beginning within 42 days of the previous menstrual period.…”

Section: Methodsmentioning

confidence: 99%

Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle

Jukic¹,

Weinberg

Wilcox³

et al. 2010

Gynecological Endocrinology

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Previous studies of hormone patterns after clinical miscarriage suggest reduced pituitary function. Hormonal effects of very early pregnancy loss (before six weeks gestation) have not been described. We used within-woman differences between menstrual cycles in urinary hormone measurements from women in the North Carolina Early Pregnancy Study to describe hormonal changes after very early pregnancy loss (n=28 early losses; 80 non-conception comparison cycles). We found lower pre-ovulatory luteinizing hormone and shorter luteal phase length after very early pregnancy loss, but the differences were non-significant (p>0.3) and smaller than those reported in the spontaneous miscarriage literature. Consistent with the reduced pituitary function reported post-spontaneous miscarriage, we found a slower rate of estrogen rise (p=0.08). There was no evidence of lower midluteal steroid levels as has been suggested for post-spontaneous miscarriage cycles. Very early pregnancy losses do not appear to influence subsequent menstrual cycles to the same degree as spontaneous miscarriages.

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Development of an assay for a biomarker of pregnancy and early fetal loss.

Cited by 46 publications

References 53 publications

Vaginal Bleeding in Very Early Pregnancy

Vaginal Bleeding in Very Early Pregnancy

High Resolution High Performance Liquid Chromatography Fingerprinting of Purified Human Chorionic Gonadotropin Demonstrates that Oxidation Is a Cause of Hormone Heterogeneity*

Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle

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