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Maternal serum insulin-like growth factor-binding protein-3 (IGFBP-3) at 11-13 weeks in preeclampsia
S Sifakis1, R Akolekar, D Kappou
1Department of Obstetrics and Gynaecology, University Hospital of Heraklion, Crete, Greece.
Insights
First-trimester insulin-like growth factor-binding protein-3 (IGFBP-3) is elevated in pregnancies that develop late preeclampsia (PE). This elevation suggests a mechanism unrelated to placental function, as indicated by uterine artery PI and PAPP-A levels.
Area of Science:
- Reproductive Endocrinology
- Maternal-Fetal Medicine
- Biochemistry
Background:
- Preeclampsia (PE) is a significant complication of pregnancy with potential adverse outcomes.
- Early identification of pregnancies at risk for PE is crucial for timely intervention.
- Maternal serum biomarkers in the first trimester may offer predictive value for PE development.
Purpose of the Study:
- To investigate whether maternal serum insulin-like growth factor-binding protein-3 (IGFBP-3) concentrations at 11-13 weeks gestation differ in pregnancies that subsequently develop preeclampsia (PE).
- To explore the relationship between first-trimester IGFBP-3 levels and other markers of placental function, such as pregnancy-associated plasma protein-A (PAPP-A) and uterine artery pulsatility index (PI), in the context of PE.
Main Methods:
- Maternal serum concentrations of IGFBP-3 and PAPP-A, along with uterine artery PI, were measured at 11-13 weeks gestation.
- A cohort of 60 pregnancies that developed PE (including 20 early-PE) and 120 unaffected pregnancies were analyzed.
- Data were analyzed using multiples of the normal median (MoM) for comparison between groups.
Main Results:
- First-trimester serum IGFBP-3 was significantly increased in pregnancies that later developed late-PE (1.16 MoM) but not early-PE (1.06 MoM).
- Early-PE was associated with increased uterine artery PI (1.41 MoM) and decreased PAPP-A (0.53 MoM), while late-PE showed less pronounced changes.
- No significant association was found between IGFBP-3 and uterine artery PI or PAPP-A in the overall PE group.
Conclusions:
- First-trimester serum IGFBP-3 is elevated in pregnancies that subsequently develop late-PE.
- The observed increase in IGFBP-3 in late-PE appears independent of impaired placentation, as assessed by uterine artery PI and PAPP-A.
- IGFBP-3 may serve as a potential biomarker for late-PE, reflecting a pathophysiology distinct from early-onset PE.
Abstract:
The objective of this study was to determine if the maternal serum concentration of insulin-like growth factor-binding protein-3 (IGFBP-3) at 11-13 week's gestation is altered in pregnancies that subsequently develop preeclampsia (PE). Maternal serum concentration of IGFBP-3, pregnancy-associated plasma protein-A (PAPP-A) and uterine artery pulsatility index (PI) were measured in 60 cases that developed PE, including 20 that developed early-PE requiring delivery before 34 weeks, and compared with 120 unaffected controls. In the unaffected pregnancies, the median multiple of the normal median (MoM) values of serum IGFBP-3, PAPP-A and uterine artery PI were 1.0 MoM. In late-PE, but not in early-PE, serum IGFBP-3 was significantly increased (1.16 and 1.06 MoM, respectively), whereas in early-PE, but not in late-PE, uterine artery PI was increased (1.41 and 1.11 MoM, respectively) and serum PAPP-A was decreased (0.53 and 0.87 MoM, respectively). In the PE group, there was no significant association between IGFBP-3 and either uterine artery PI (P=0.775) or maternal serum PAPP-A (P=0.275). First-trimester serum IGFBP-3 is increased in pregnancies that subsequently develop late-PE in a mechanism that is unrelated to impaired placentation, as reflected in uterine artery PI and serum PAPP-A.
