Early Detection of Preeclampsia Using Inhibin A and Other Second-Trimester Serum Markers

Abstract

Objective: The purpose of this study was to determine whether second-trimester maternal serum markers including inhibin A are useful for the detection of preeclampsia. Methods: Between January 2005 and March 2009, we analyzed the data of 4,764 subjects who underwent second-trimester multiple-marker screening for Down syndrome. Serum samples were assayed at 15+0 to 20+6 weeks for maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotrophin (hCG), unconjugated estriol (uE₃) and inhibin A. We reviewed all medical records retrospectively, and assessed the relationships of several markers with preeclampsia using logistic regression analysis. Results: The study sample included 41 patients who developed preeclampsia and a control group consisting of the other 4,723 healthy subjects treated between January 2005 and March 2009. There were no significant differences in gestational ages at blood sampling, maternal weights, gravidity and parity between the two groups. However, the mean ages, Apgar scores, gestational age at delivery and neonatal weights were significantly different between the study group and the control group. The levels of markers in the study group were significantly increased compared to the control group, 1.76 ± 2.68 for inhibin A, 1.18 ± 0.69 for MSAFP, and 1.62 ± 1.18 for hCG, but uE₃ did not differ significantly between the two groups. The AUC of inhibin A was 0.715, but the AUC of a three-marker combination model (0.800) was even better. A mid-trimester inhibin A concentration of 1.5 MoM or greater had a sensitivity of 60% and a false-positive rate of 16% for the prediction of preeclampsia. Inhibin A was the best predictor of preeclampsia. Three other markers were reliable predictive markers of preeclampsia. Conclusions: Inhibin A and other second-trimester serum markers may be useful for early detection of preeclampsia. Inhibin A was in fact the most important predictable marker among the markers we surveyed. The results of this study support those of previous studies, and provide quantified data elucidating the occurrence of preeclampsia.

Novel fetal and maternal sonographic findings in confirmed cases of Beckwith–Wiedemann syndrome

“…Ree et al . examined the performance of second trimester biochemical markers in the screening for pre‐eclampsia and found that, when using beta‐hCG with a cut‐off of 2.5 MoM, detection and false positive rate is 17.0% and 4.2% …”

“…cut-off of 2.5 MoM, detection and false positive rate is 17.0% and 4.2%. 21 It was suggested that increased AFP is related to a disruption at the fetal-maternal interface, thus permitting transfer of AFP into the maternal circulation. 22 Abnormally increased levels of hCG may be because of decreased placental perfusion with subsequent reduced oxygenation of the cytotrophoblast.…”

First-Trimester and Second-Trimester Maternal Serum Biomarkers as Predictors of Placental Abruption

“…Concentrations of circulating dimeric inhibin-A rapidly rise in early pregnancy, fall after 12 weeks of gestation, remain low in the second trimester, and gradually increases in the latter half of pregnancy (29, 30). Previous studies did not report associations of Inhibin-A both at ≤5 th and ≥95 th percentiles in relation to abruption.…”

Преконцепційний Відбір Жінок Групи Високого Ризику Розвитку Пізнього Гестозу (Огляд Літератури)

“…Інгібін А насправді є найважливішим передбачуваним маркером. Результати цього дослідження підтверджують результати попередніх досліджень та надають кількісні дані, що вказують на виникнення ПЕ [28]. Враховуючи результати цього дослідження, можна зробити висновок, що MOM рівня інгібіну А у материнській сироватці крові під час другого етапу тестів на скринінг вагітності дозволяє прогнозувати частоту та тяжкість розвитку прееклампсії у вагітних жінок [7].…”