Expression and Diagnostic Value of Serum Protein Z, Protein Z-dependent Protease Inhibitor and Coagulation-related Indicators in Foetal Growth Restriction.

Abstract

Objective: This study aimed to explore the expression and associations between levels of serum protein Z (PZ), protein Z-dependent protease inhibitor (ZPI), and coagulation-related indicators and foetal growth restriction (FGR).Methods: A total of 50 pregnant women with FGR, 50 healthy pregnant women (Healthy control, HC), and 30 childbearing-age women without pregnancy group (Blank control, BC) were collected in this study. The serum PZ, ZPI, protein C (PC), protein C (PS), and antithrombin III (ATIII) levels of women in each group were determined and compared. Moreover, correlations between these indices and FGR were assessed using Spearman analysis and diagnostic values of these indices for FGR were evaluated using the receiver operating characteristics (ROC) curves.Results: Serum levels of PZ, ZPI, PC, PS, and ATIII were significantly downregulated in the HC and FGR groups compared with the BC group (P <0.001), while PZ, ZPI, PS, and ATIII levels in the FGR groups were significantly lower than that in the HC group (P <0.01). PZ serum concentration was positively correlated with ZPI concentration in the HC and FGR groups, and PZ and ZPI levels were negatively correlated with FGR (r = -0.198, r = -0.247, P <0.05). Combined of PZ, ZPI, PS, and ATIII performed a better value than each of them with AUC of 0.935 (95% CI=0.890-0.981), a sensitivity of 0.920, and a specificity of 0.800.Conclusion: Serum PZ, ZPI, PS, and ATIII were significantly decreased in pregnant women with FGR and could be used for FGR screening in pregnant women.