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Maternal serum placental protein 13 at eleven to thirteen weeks in chromosomally abnormal pregnancies
Ranjit Akolekar1, José María Pérez Penco, Evdoxia Skyfta
1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
Insights
Maternal serum placental protein 13 (PP13) levels are altered in certain aneuploidies but do not improve first-trimester aneuploidy screening when added to existing markers.
Area of Science:
- Prenatal diagnosis
- Biochemistry
- Genetics
Background:
- Placental protein 13 (PP13) is a protein produced by the placenta.
- Its serum concentration may be altered in pregnancies with chromosomal abnormalities.
Purpose of the Study:
- To determine if maternal serum PP13 levels differ in chromosomally abnormal pregnancies.
- To assess the utility of PP13 in first-trimester aneuploidy screening (11-13 weeks).
Main Methods:
- Maternal serum PP13 concentrations were measured at 11-13 weeks in 536 euploid and 134 aneuploid pregnancies.
- Aneuploidies included trisomy 21, 18, 13, Turner syndrome, and triploidy.
- PP13 levels were compared between groups and correlated with PAPP-A and free beta-hCG.
Main Results:
- Serum PP13 levels were significantly decreased in trisomy 18, 13, Turner syndrome, and triploidy, but not trisomy 21.
- PP13 showed significant associations with PAPP-A and free beta-hCG in both euploid and aneuploid pregnancies.
- Adding PP13 to existing screening markers (maternal age, nuchal translucency, PAPP-A, free beta-hCG) did not enhance the prediction of trisomy 13 and 18.
Conclusions:
- Maternal serum PP13 measurement at 11-13 weeks does not improve the performance of current aneuploidy screening algorithms.
- PP13 is not a valuable addition to existing first-trimester screening protocols for chromosomal abnormalities.
Objective:
To investigate whether the maternal serum concentration of placental protein 13 (PP13) is altered in chromosomally abnormal pregnancies and to examine the potential value of this placental protein in screening for aneuploidies at 11-13 weeks.
Methods:
The maternal serum concentration of PP13 at 11-13 weeks was compared in 536 euploid and 134 aneuploid pregnancies (trisomy 21: n = 49; trisomy 18: n = 28; trisomy 13: n = 19; Turner syndrome: n = 28; triploidy: n = 10).
Results:
Serum PP13, expressed as multiples of the median (MoM) of the euploid group, was not significantly different in trisomy 21 (1.12 MoM) pregnancies, but the levels were decreased in trisomy 18 (0.75 MoM), trisomy 13 (0.65 MoM), Turner syndrome (0.61 MoM) and triploidy (0.19 MoM). In both euploid and aneuploid pregnancies there was a significant association of serum PP13 with both serum pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (beta-hCG; p < 0.0001 for both). Logistic regression analysis demonstrated that the addition of serum PP13 did not improve the prediction of trisomy 13 and 18 provided by a combination of maternal age, nuchal translucency, and serum free beta-hCG and PAPP-A.
Conclusion:
The measurement of maternal serum PP13 at 11-13 weeks does not improve the performance of screening for aneuploidies achieved by current algorithms.
