OP01.14: Elevation of Pentraxin (PTX3) levels in the first trimester of pregnancy in women with subsequent pre‐eclampsia

Abstract

Objectives: Pentraxin (PTX3) is an inflammatory molecule expressed by a variety of cells in response to inflammatory stimuli. Maternal plasma PTX3 levels are only slightly elevated during normal pregnancy but significant increases in established pre-eclampsia (PE) are reported. The aim of this study was to compare PTX3 levels measured in the first trimester of pregnancy in women who subsequently developed complications of placental insufficiency, to those with normal pregnancy outcome. Methods: Maternal plasma was collected at the routine 11-14 week scan and stored at −80 • C. Following delivery PTX3 levels were measured in three groups of women : Group 1, who developed PE requiring delivery before 37 weeks and where birth weight was above the 5th centile; Group 2, affected with fetal growth restriction (FGR) defined as birth weight below the 5 th centile for gestation, abnormal fetal arterial Doppler findings and delivery before 37 weeks (normotensive); and Group 3, who had uncomplicated pregnancies. After excluding evidence of non-normality, the Scheffé test for multiple comparisons was used to look for differences between groups. Results: There were 16 cases in Group 1, 12 cases in Group 2, and 60 normal pregnancies (Group 3). In Group 1 mean PTX3 levels were 7.31 ng/mL (standard deviation 4.12 ng/mL), and these were significantly higher than in Group 2 (Mean = 4.82 (2.35), P = 0.039) and Group 3 (Mean = 4.92 (1.94), P = 0.0046). There were no significant differences between PTX3 levels in Groups 2 and 3. Levels above the 95 th percentile for PTX3 in normal pregnancy (8.55 ng/mL) were found in 5/16 (31%) of those that subsequently developed PE. Conclusions: PTX3 levels are elevated in the first trimester in women who subsequently develop PE, but are normal in those with FGR. This supports the hypothesis of an excessive maternal inflammatory response to pregnancy in the etiology of PE. PTX3 levels above the normal 95th centile at 11-14 weeks are found in one-third of cases with subsequent PE. OP01.15PAPP-A and fetal growth from week 12 to week 20