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ADAM12s and PP13 as first trimester screening markers for adverse pregnancy outcome
Koen L Deurloo1, Ingeborg H Linskens, Martijn W Heymans
1Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands. kdeurloo@diakhuis.nl
Insights
First trimester screening for adverse pregnancy outcomes using ADAM12s and PP13 showed limited predictive value. However, decreased ADAM12s levels in early pregnancy are linked to gestational hypertension (GH).
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Biomarker Discovery
Background:
- Preeclampsia (PE), gestational hypertension (GH), and small-for-gestational-age (SGA) fetuses are significant adverse pregnancy outcomes.
- Early pregnancy screening is crucial for timely intervention and improved maternal and fetal health.
Purpose of the Study:
- To evaluate the screening performance of first-trimester maternal serum A-disintegrin-and-metalloprotease 12-s (ADAM12s) and placental protein 13 (PP13) for PE, GH, and SGA.
- To determine if combined measurements of ADAM12s and PP13 enhance predictive accuracy.
Main Methods:
- A retrospective case-control study involving 220 pregnant women matched for gestational and maternal age.
- Maternal serum levels of ADAM12s and PP13 were measured in the first trimester.
- Screening performance was assessed using receiver operator characteristic (ROC) curves and area under the curve (AUC) analysis.
Main Results:
- ADAM12s and PP13 showed moderate AUC values for predicting PE, GH, and SGA, with no significant improvement when combined.
- At 80% specificity, ADAM12s achieved a 52% detection rate for GH.
- Individual marker performance varied, with ADAM12s showing a higher AUC for GH (0.68) compared to PE (0.63) and SGA (0.59).
Conclusions:
- Combined ADAM12s and PP13 measurements do not improve the prediction of adverse pregnancy outcomes.
- Decreased first-trimester ADAM12s levels are associated with gestational hypertension (GH).
- Further research may explore the role of ADAM12s as a specific biomarker for GH.
Background:
The aim of the study was to assess the screening performance of first trimester maternal serum measurements of A-disintegrin-and-metalloprotease 12-s (ADAM12s) and placental protein 13 (PP13) for preeclampsia (PE), gestational hypertension (GH) and small-for-gestational-age (SGA) fetuses.
Methods:
In this retrospective case-control study 220 pregnant women were matched for gestational and maternal age at sampling. Results were expressed as multiples of the median (MoM) and compared using Kruskal-Wallis and Mann-Whitney U-test. Screening performance was assessed by receiver operator characteristics (ROC) curves and area under the curve (AUC).
Results:
Seventeen cases of PE, 30 cases of GH and eight cases of SGA fetuses were matched with 165 controls. ROC-analysis yielded AUCs for ADAM12s and PP13 of 0.63 and 0.59 for PE, 0.68 and 0.57 for GH and 0.59 and 0.62 for SGA, respectively. Combined ADAM12 and PP13 did not improve the AUC value. When the specificity was set at 80%, corresponding detection rate of ADAM12s was 52% for GH.
Conclusions:
Combined ADAM12s and PP13 measurements do not predict adverse pregnancy outcome, but decreased first trimester ADAM12s levels are associated with GH.
