First-trimester maternal serum a disintegrin and metalloprotease 12 (ADAM12) and adverse pregnancy outcome
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Published on: June 24, 2020
Leona C Y Poon1, Teodora Chelemen, Oriana Granvillano
1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, United Kingdom.
Insights
Maternal serum a disintegrin and metalloprotease (ADAM12) levels in early pregnancy do not reliably predict preeclampsia, small for gestational age (SGA) neonates, or preterm delivery. While ADAM12 correlates with pregnancy-associated plasma protein A, it lacks predictive value for these adverse pregnancy outcomes.
Area of Science:
- Reproductive biology
- Maternal-fetal medicine
- Biochemistry
Background:
- Preeclampsia, small for gestational age (SGA), and spontaneous preterm delivery are significant causes of perinatal morbidity.
- Early identification of pregnancies at risk is crucial for timely intervention.
- Biomarkers in maternal serum during the first trimester are being investigated for predictive potential.
Purpose of the Study:
- To investigate the association between first-trimester maternal serum a disintegrin and metalloprotease (ADAM12) concentrations and the development of preeclampsia, SGA neonates, and spontaneous preterm delivery.
- To evaluate ADAM12 as a potential predictive marker for adverse pregnancy outcomes.
Main Methods:
- Maternal serum ADAM12 concentrations were measured in the first trimester (11-14 weeks gestation) in cases of preeclampsia, gestational hypertension, SGA, spontaneous preterm delivery, and controls.
- Regression analysis identified predictors of ADAM12, and levels were expressed as multiples of the median (MoM).
- ADAM12 MoM levels were compared between case groups and controls.
Main Results:
- ADAM12 concentration increased with fetal crown-rump length and decreased with maternal weight in controls.
- ADAM12 showed a significant correlation with pregnancy-associated plasma protein A (PPAA) and birth weight percentile.
- Median ADAM12 MoM was lower in the SGA group (0.848 MoM) but not significantly different in preeclampsia (0.954 MoM), gestational hypertension (1.013 MoM), or spontaneous preterm delivery (1.048 MoM) compared to controls (1.011 MoM).
Conclusions:
- Maternal serum ADAM12 concentration is positively correlated with PPAA.
- Measurement of ADAM12 in the first trimester does not offer a useful prediction for SGA, preeclampsia, or spontaneous preterm delivery.
- ADAM12 is not a reliable biomarker for predicting these adverse pregnancy outcomes.
Objective:
To examine the possible association of maternal serum a disintegrin and metalloprotease (ADAM12) in the first trimester of pregnancy and subsequent development of preeclampsia, delivery of small for gestational age (SGA) neonates, and spontaneous preterm delivery.
Methods:
The maternal serum concentration of ADAM12 at 11 0/7 to 13 6/7 weeks was measured in 128 cases of preeclampsia, 88 cases of gestational hypertension, 296 cases with SGA neonates, 58 cases of spontaneous preterm delivery, and 570 controls. Regression analysis was used to determine which of the maternal factors and fetal crown rump length were significant predictors of ADAM12 in the control group, and from the regression model the value in each case and control was expressed as a multiple of median (MoM). The levels of ADAM12 MoM were compared in cases and controls.
Results:
In the control group the concentration of ADAM12 increased with fetal crown rump length, decreased with maternal weight and was higher in African-American than in white women. There was a significant association between ADAM12 and pregnancy-associated plasma protein A (r=0.417, P<.001) and between each metabolite and birth weight percentile (r=0.176, P<.001 and r=0.109, P=.009). In the SGA group, the median ADAM12 concentration (0.848 MoM) was lower (P<.001), but in pregnancies complicated by preeclampsia (0.954 MoM), gestational hypertension (1.013 MoM), and spontaneous preterm delivery (1.048 MoM) the levels were not significantly different from controls (1.011 MoM).
Conclusion:
There is a good correlation between the maternal serum ADAM12 and pregnancy-associated plasma protein A concentration. Measurement of ADAM12 does not provide useful prediction of SGA, preeclampsia, or spontaneous preterm delivery.
Level Of Evidence:
II.
