Clinical Value of Serum APOC1, LMNA, and TPM4 in Predicting Fetal Cardiac Abnormalities in Elderly Parturients

This study aimed to explore the clinical value of serum APOC1, LMNA, and TPM4 in predicting fetal cardiac abnormalities in elderly parturients.

A retrospective study was conducted on 108 elderly (≥ 35 years old) pregnant women suspected of having fetal heart abnormalities (high-risk cohort). They were divided into a normal group (42 cases) and an abnormal group (66 cases). APOC1, LMNA, and TPM4 with significant differences were selected from 10 cardiac related proteins in blood samples collected at 18-24 weeks of pregnancy. A combined prediction model was constructed using logistic regression.

In the abnormal group, APOC1 level was increased, but LMNA and TPM4 levels were decreased compared with the normal group (both P<0.05). The level of APOC1 was elevated, but LMNA and TPM4 levels were declined with the severity of cardiac abnormalities,(P<0.05). After adjusting for folate supplementation history, APOC1 (OR=1.85), LMNA (OR=0.52), and TPM4 (OR=0.41) were independent predictors of fetal cardiac abnormalities (all P<0.001). The AUC of the joint model for predicting fetal cardiac abnormalities was 0.906, with a sensitivity of 98.49% and a specificity of 76.19%, all of which were superior to individual indicator (P<0.05).

The combined detection of APOC1, LMNA, and TPM4 has high predictive value for fetal cardiac abnormalities in elderly mothers, but external validation is needed to confirm clinical applicability.