Screening models combining maternal characteristics and multiple markers for the early prediction of preeclampsia in pregnancy: a nested case-control study

作者全名："Chen, Li; Pi, Yan; Chang, Kai; Luo, Sifu; Peng, Zhuyun; Chen, Ming; Yu, Lili"

作者地址："[Chen, Li; Yu, Lili] Chongqing Med Univ, Dept Obstet & Gynecol, Affiliated Hosp 3, 1 Shuanghu Branch Rd, Chongqing 400112, Peoples R China; [Pi, Yan] Chongqing Med Univ, Dept Rehabil Med, Affiliated Hosp 1, Chongqing, Peoples R China; [Chang, Kai; Chen, Ming] Army Med Univ, Southwest Hosp, Dept Clin Lab Med, 30 Gaotanyan Rd, Chongqing 400038, Peoples R China; [Luo, Sifu; Peng, Zhuyun] Army Med Univ, Daping Hosp, Inst Surg Res, Dept Obstet & Gynecol, Chongqing, Peoples R China"

通信作者："Yu, LL (通讯作者)，Chongqing Med Univ, Dept Obstet & Gynecol, Affiliated Hosp 3, 1 Shuanghu Branch Rd, Chongqing 400112, Peoples R China.; Chen, M (通讯作者)，Army Med Univ, Southwest Hosp, Dept Clin Lab Med, 30 Gaotanyan Rd, Chongqing 400038, Peoples R China."

来源：JOURNAL OF OBSTETRICS AND GYNAECOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000802072200001

JCR分区：Q4

影响因子：1.3

年份：2022

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Preeclampsia; biomarker; screening; pregnancy

摘要："To identify maternal laboratory markers to predict the risk of preeclampsia (PE) in different stages of pregnancy, we analysed 67, 25, and 73, pregnancies developing PE at 11-13, 16-20, and 24-28 wks, respectively. Routine laboratory markers were measured in whole blood or serum and binary logistic regression analysis was used to identify predictive models. At 11-13 wks of gestation, patients who went on to develop PE showed significantly higher concentrations of alanine aminotransferase, aspartate aminotransferase, alpha-L-fucosidase, 5 '-nucleotidase, glutamyl transpeptidase, cholinesterase, and uric acid; plateletcrit was also higher. At 16-20 wks, inhibin A concentration and plateletcrit were significantly elevated. At 24-28 wks, platelets, plateletcrit, and glucose concentration were significantly elevated. Logistic regression analysis showed that an elevation in 5 '-nucleotidase was independently associated with PE at 11-13 wks. The combination of inhibin A, diastolic blood pressure, and body mass index was a significant predictor for PE at 16-20 wks, while the combination of glucose and systolic blood pressure was a significant predictor for PE at 24-28 wks. In conclusion, when combined with maternal characteristics, the measurement of 5 '-nucleotidase, inhibin A, and glucose levels, represents a potentially valuable risk assessment for PE.Impact statement What is already known on this subject? Preeclampsia (PE) may be viewed as a spectrum of disorders with a severity that is reflected in the levels of specific biomarkers. Consequently, there is a clear need for additional biomarkers that can be used to stratify pregnancies as high or low risk soon after conception. What do the results of this study add? At 11-13 wks of gestation, maternal assays for platelets, plateletcrit, alanine aminotransferase, aspartate aminotransferase, alpha-L-fucosidase, 5 '-nucleotidase, glutamyl transpeptidase, cholinesterase, and uric acid, demonstrated significantly higher values in patients with PE when compared with normal controls. Furthermore, assay results for inhibin A and platelets showed increased values at 16-20 wks of gestation. Assays performed at 24-28 wks of gestation revealed elevated levels of platelets, plateletcrit, and glucose. Our analysis indicated that increases in the levels of 5 '-nucleotidase, inhibin A, and glucose, are effective and significant biomarkers that could be used in combination with maternal characteristics to screen for PE at 11-13, 16-20, and 24-28 wks of gestation, respectively. These findings provide a new basis for our understanding of the aetiology underlying PE. What are the implications of these findings for clinical practice and/or further research? Further studies that consider the entire population are now needed and should include the investigation of laboratory markers across different stages of pregnancy. Long-term follow up would also be necessary if we are to explore the full role of laboratory markers in the pathophysiology of PE."

基金机构：National Natural Sciences Foundation of China [81571495]

基金资助正文：This study was supported by the National Natural Sciences Foundation of China [grant number: 81571495].