Diagnostic efficacy of aneuploidy markers correlated with early onset preeclampsia

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Biochemistry

Background:

• Preeclampsia (PE) is a major cause of maternal and fetal morbidity.
• Early intervention with low-dose aspirin before 16 weeks of gestation is effective in preventing PE.
• Accurate prediction of PE onset is crucial for timely treatment initiation.

Purpose of the Study:

• To evaluate the predictive performance of pregnancy-associated plasma protein A (PAPP-A) and aneuploidy markers for preeclampsia onset.
• To compare the utility of individual markers and their combinations in predicting early-onset preeclampsia (EOPE).
• To establish cutoff values for these markers to guide aspirin administration timing.

Main Methods:

• Serum levels of PAPP-A, alpha-fetoprotein (AFP), and human chorionic gonadotropin (hCG) were analyzed in 1053 pregnant women.
• Participants were categorized into normotensive, late-onset PE, and early-onset PE groups.
• The predictive values of marker ratios (AFP/PAPP-A, hCG/PAPP-A) and their combinations for EOPE were assessed.

Main Results:

• Specific ratios, AFP/PAPP-A > 6.89 and hCG/PAPP-A > 7.94, were significantly associated with EOPE (LR 6.52 and 5.77, respectively).
• The combination of these markers demonstrated higher accuracy in predicting EOPE compared to individual markers.
• Established cutoff values provide a basis for early PE risk assessment.

Conclusions:

• PAPP-A and aneuploidy markers, particularly in combination, are valuable predictors of early-onset preeclampsia.
• These markers and their defined thresholds can aid in identifying women who would benefit from early aspirin therapy.
• Optimizing aspirin treatment timing based on these predictive markers can improve maternal and fetal outcomes.