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Maternal serum adiponectin at 11-13 weeks of gestation in preeclampsia
Surabhi Nanda1, Christina K H Yu, Laura Giurcaneanu
1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
Insights
Maternal serum adiponectin levels are elevated in early preeclampsia (PE) but not late PE, independent of placental function. These findings suggest adiponectin may not be a reliable screening marker for PE.
Area of Science:
- Reproductive Endocrinology
- Maternal-Fetal Medicine
- Biomarker Discovery
Background:
- Preeclampsia (PE) is a significant complication of pregnancy.
- Early identification of PE risk is crucial for improved maternal and fetal outcomes.
- Adiponectin's role in PE pathogenesis requires further elucidation.
Purpose of the Study:
- To investigate first-trimester maternal serum adiponectin levels in pregnancies that develop PE.
- To assess the relationship between adiponectin, pregnancy-associated plasma protein-A (PAPP-A), and uterine artery pulsatility index (PI).
- To evaluate adiponectin's utility in screening for PE.
Main Methods:
- Serum adiponectin, PAPP-A, and uterine artery PI were measured at 11-13 weeks gestation.
- Comparison of median multiples of the unaffected median (MoM) in early PE, late PE, and control groups.
- Correlation analysis between adiponectin, PAPP-A, and uterine artery PI in PE cases.
Main Results:
- Uterine artery PI MoM was elevated, and PAPP-A MoM was decreased in both early and late PE compared to controls.
- Adiponectin MoM was significantly increased in early PE but not in late PE.
- Serum adiponectin did not enhance the predictive performance of existing PE screening markers.
Conclusions:
- First-trimester serum adiponectin levels are elevated in early PE.
- This elevation appears unrelated to impaired placentation.
- Adiponectin is not a useful addition to current screening protocols for PE.
Objective:
To determine whether the maternal serum levels of adiponectin in the first trimester of pregnancy are altered in cases that develop preeclampsia (PE) and whether the levels are related to pregnancy-associated plasma protein-A (PAPP-A) and uterine artery pulsatility index (PI).
Methods:
Serum adiponectin, PAPP-A and uterine artery PI were measured at 11-13 weeks in 90 cases that developed PE, including 30 that required delivery before 34 weeks (early PE) and 300 unaffected controls. The median adiponectin, PAPP-A and uterine artery PI multiple of the unaffected median (MoM) in the outcome groups were compared.
Results:
In both early PE and late PE, compared to controls, uterine artery PI MoM was increased (1.32 and 1.05 vs. 1.02) and PAPP-A MoM was decreased (0.61 and 0.84 vs. 1.00), whereas adiponectin MoM was increased in early PE but not in late PE (1.32 and 1.05 vs. 1.02). In the PE group, there was no significant association between adiponectin and PAPP-A or uterine artery PI. Serum adiponectin did not improve the performance of screening for PE provided by a combination of the maternal factors, uterine artery PI and serum PAPP-A.
Conclusion:
Serum adiponectin levels at 11-13 weeks are increased in women that develop early PE by a mechanism unrelated to impaired placentation.
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