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Updated: May 9, 2026
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The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology In Vivo
Published on: August 2, 2017
Ischemia-modified albumin in pregnancy
Alberto Rossi1, Nadia Bortolotti, Sara Vescovo
1Obstetrics and Gynecology Department, University Hospital of Udine, Udine, Italy.
Summary
Maternal serum ischemia-modified albumin (IMA) and pregnancy-associated plasma protein A (PAPP-A) levels in the first trimester can help identify fetuses that are small-for-gestational-age (SGA). These biomarkers may indicate early placental dysfunction.
Area of Science:
- Biochemistry
- Obstetrics
- Perinatology
Background:
- A hypoxic intrauterine environment is crucial for early trophoblast development in normal pregnancies.
- Maternal serum ischemia-modified albumin (IMA) levels rise due to oxidative stress during placental development.
- Small-for-gestational-age (SGA) fetuses may result from placental dysfunction.
Purpose of the Study:
- To investigate ischemia-modified albumin (IMA) and pregnancy-associated plasma protein A (PAPP-A) levels in mothers with SGA fetuses compared to normal pregnancies.
- To determine if these biomarkers can predict SGA fetuses early in gestation.
Main Methods:
- A prospective study involving 81 pregnant women from June 2010 to June 2011.
- Serum total albumin, IMA, and PAPP-A concentrations were measured in the 1st trimester, 2nd trimester, and postpartum.
- Women were categorized into appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) fetal groups, with non-pregnant women as controls.
Main Results:
- Serum IMA concentrations increased throughout gestation.
- In the 1st trimester, mothers of SGA fetuses had significantly higher IMA levels (p<0.05).
- Conversely, PAPP-A multiples of median (MoM) values were significantly lower in the SGA group during the 1st trimester (p<0.05).
Conclusions:
- Elevated first-trimester IMA and low PAPP-A levels were observed in mothers carrying SGA fetuses.
- These findings suggest early placental changes detectable before clinical SGA manifestation.
- IMA and PAPP-A may serve as potential early biomarkers for predicting SGA fetuses.
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