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The prognostic value of first-trimester cystatin C levels for gestational complications
Insights
First-trimester cystatin C levels may predict pregnancy complications like preterm delivery and premature rupture of membranes (PROM). Higher cystatin C indicates increased risk, suggesting its role beyond renal function monitoring.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Biomarkers in Pregnancy
Background:
- Predicting long-term pregnancy complications remains a clinical challenge.
- Biomarkers in early pregnancy can offer valuable prognostic information.
- Cystatin C's role in pregnancy complications beyond renal function is under investigation.
Purpose of the Study:
- To evaluate the predictive value of first-trimester cystatin C levels for long-term pregnancy complications.
- To assess the association between early pregnancy cystatin C levels and adverse gestational outcomes.
Main Methods:
- A cross-sectional study included 174 women with antenatal follow-up.
- First-trimester cystatin C, BUN, creatinine, and eGFR were measured.
- Gestational complications and mode of delivery were recorded.
Main Results:
- First-trimester cystatin C levels were significantly higher in pregnancies with preterm delivery and PROM.
- A cystatin C cutoff of 0.505 mg/L showed 91.9% sensitivity for preterm delivery and PROM.
- The negative predictive value for preterm delivery and PROM was 92.3%.
Conclusions:
- First-trimester cystatin C is a promising biomarker for predicting preterm delivery and PROM.
- Elevated cystatin C levels in early pregnancy are associated with adverse outcomes.
- Cystatin C may serve as an indicator of pregnancy complications beyond its established role in renal function.
Aims:
This study is designed to evaluate predictive value of first-trimester cystatin C levels for long-term pregnancy complications.
Methods:
The cross-sectional study population consisted of patients who admitted to outpatient clinic of a Maternity Hospital between September 2013 and December 2014. Among the 203 participants who accepted to participate in the study, 174 subjects who continued antenatal follow-up in the same clinic were included in the final analyses. Cystatin C, blood urea nitrogen, Creatinine levels and estimated glomerular filtration rates were evaluated in the first-trimester routine antenatal visit. Mode of delivery and gestational complications were noted.
Results:
First-trimester cystatin C levels were significantly higher in cases complicated with preterm delivery and premature rupture of membrane (PROM) compared to uncomplicated ones (0.58±0.07 vs. 0.55±0.07, P=0.041, and 0.58±0.07 vs. 0.55±0.07, P=0.036). With a cutoff value of 0.505 mg/L, sensitivity of cystatin C for preterm delivery and PROM was 91.9% and specificity was 27.7% with a negative predictive value of 92.3% and a positive predictive value of 26.6%.
Conclusion:
Detection of cystatin C levels in the first trimester of pregnancy for the prediction of preterm/PROM seems as a promising preliminary data. The relatively higher first-trimester cystatin C levels in complicated pregnancies are conspicuous. The results imply that in pregnancy cystatin C might be more than a marker for renal function.
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