Correlation Between Second Trimester Maternal Serum Inhibin-A and Human Chorionic Gonadotrophin for the Prediction of Pre-eclampsia

Aquilina, J.; Maplethorpe, Richard; Ellis, Patricia; Harrington, K

doi:10.1053/plac.2000.0540

Cited by 46 publications

(24 citation statements)

References 24 publications

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“…Pregnancy-associated plasma protein A (PAPP-A) and β-human chorionic gonadotropin (β- hCG) are used as first-trimester screening, while maternal serum α-fetoprotein (AFP), β-hCG, unconjugated estriol (uE 3 ), and inhibin A (InhA) comprise the standard second-trimester screening [17,18]. Among these biochemical markers, PAPP-A and InhA levels are associated with subsequent PE [19,20,21,22], but their predictive value for PE remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Early Prediction of Hypertensive Disorders of Pregnancy Using Cell-Free Fetal DNA, Cell-Free Total DNA, and Biochemical Markers

Kim

Kim²,

Park³

et al. 2016

Fetal Diagn Ther

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Objective: To evaluate the predictive value of separate and combined tests using cell-free fetal DNA (cffDNA), cell-free total DNA (cfDNA), and biochemical markers for the early detection of pregnancies with hypertensive disorders. Methods: A nested case-control study was conducted with 135 singleton pregnancies including 17 gestational hypertension cases, 34 preeclampsia (PE) cases, and 84 controls. We performed real-time quantitative PCR to measure levels of DSCR3 and RASSF1A as cffDNA markers and HYP2 as a cfDNA marker in the first and early second trimesters. Levels of pregnancy-associated plasma protein A (PAPP-A), α-fetoprotein, β-human chorionic gonadotropin, unconjugated estriol, and inhibin A were also determined. Results: Compared with controls, the median levels and multiples of the median (MoM) values of HYP2 were significantly higher in the PE and hypertensive disorders of pregnancy (HDP) groups at 6-14 and 15-23 weeks. Frist-trimester PAPP-A MoM was significantly lower in PE and HDP than in controls. For PE and HDP, the best model included the first-trimester DSCR3, HYP2, and PAPP-A MoM values achieving detection rates of 67 and 58% at a fixed 10% false-positive rate, respectively [area under the receiver operating characteristic curve 0.832 (95% CI 0.689-0.928) for PE; 0.751 (0.607-0.863) for HDP]. Discussion: The study demonstrates the potential utility of combined first-trimester cffDNA, cfDNA, and PAPP-A for the early prediction of PE.

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Section: Introductionmentioning

confidence: 99%

Early Prediction of Hypertensive Disorders of Pregnancy Using Cell-Free Fetal DNA, Cell-Free Total DNA, and Biochemical Markers

Kim

Kim²,

Park³

et al. 2016

Fetal Diagn Ther

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“…1 In the survey there were 383 cases of eclampsia, among which seven mothers and 30 babies died. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] Inconsistent results have been published on alpha-fetoprotein (AFP) and the subsequent development of pre-eclampsia 6 7 9 17-19 and one study suggested that lower unconjugated estriol (uE 3 ) was associated with the subsequent development of pre-eclampsia. 2 Several studies have measured diVerent markers (all used in antenatal screening for Down's syndrome 3 ) in stored serum samples collected before the onset of pre-eclampsia.…”

mentioning

confidence: 99%

Multiple marker second trimester serum screening for pre-eclampsia

Wald¹,

Morris²

2001

J Med Screen

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“…Nevertheless, we found that the inhibin-A level was a more sensitive marker for predicting subsequent preeclampsia than the hCG level in the second trimester. Addition of the hCG level to the inhibin-A level did not improve the screening efficacy for preeclampsia in a previous study [16]. Significantly lower PAPP-A levels and higher inhibin-A and hCG levels were observed in women who developed preeclampsia than in those who did not, but the levels of unconjugated estriol and MSAFP had no predictive power.…”

Section: Discussionmentioning

confidence: 81%

“…Among these markers, the levels of pregnancy-associated plasma protein (PAPP-A) and inhibin-A are positively associated with subsequent preeclampsia [13-16]. However, the screening efficacy of these markers for preeclampsia remains to be determined.…”

Section: Introductionmentioning

confidence: 99%

Screening models using multiple markers for early detection of late-onset preeclampsia in low-risk pregnancy

Park

Kim

Jung

et al. 2014

BMC Pregnancy Childbirth

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BackgroundOur primary objective was to establish a cutoff value for the soluble fms-like tyrosine kinase 1(sFlt-1)/placental growth factor (PlGF) ratio measured using the Elecsys assay to predict late-onset preeclampsia in low-risk pregnancies. Our secondary objective was to evaluate the ability of combination models using Elecsys data, second trimester uterine artery (UtA) Doppler ultrasonography measurements, and the serum fetoplacental protein levels used for Down’s syndrome screening, to predict preeclampsia.MethodsThis prospective cohort study included 262 pregnant women with a low risk of preeclampsia. Plasma levels of pregnancy-associated plasma protein-A (PAPP-A) and serum levels of alpha-fetoprotein, unconjugated estriol, human chorionic gonadotropin, and inhibin-A were measured, and sFlt-1/PlGF ratios were calculated. All women underwent UtA Doppler ultrasonography at 20 to 24 weeks of gestation.ResultsEight of the 262 women (3.0%) developed late-onset preeclampsia. Receiver operating characteristic curve analysis showed that the third trimester sFlt-1/PlGF ratio yielded the best detection rate (DR) for preeclampsia at a fixed false-positive rate (FPR) of 10%, followed by the second trimester sFlt-1/PlGF ratio, sFlt-1 level, and PlGF level. Binary logistic regression analysis was used to determine the five best combination models for early detection of late-onset preeclampsia. The combination of the PAPP-A level and the second trimester sFlt-1/PlGF ratio yielded a DR of 87.5% at a fixed FPR of 5%, the combination of second and third trimester sFlt-1/PlGF ratios yielded a DR of 87.5% at a fixed FPR of 10%, the combination of body mass index and the second trimester sFlt-1 level yielded a DR of 87.5% at a fixed FPR of 10%, the combination of the PAPP-A and inhibin-A levels yielded a DR of 50% at a fixed FPR of 10%, and the combination of the PAPP-A level and the third trimester sFlt-1/PlGF ratio yielded a DR of 62.5% at a fixed FPR of 10%.ConclusionsThe combination of the PAPP-A level and the second trimester sFlt-1/PlGF ratio, and the combination of the second trimester sFlt-1 level with body mass index, were better predictors of late-onset preeclampsia than any individual marker.

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Correlation Between Second Trimester Maternal Serum Inhibin-A and Human Chorionic Gonadotrophin for the Prediction of Pre-eclampsia

Cited by 46 publications

References 24 publications

Early Prediction of Hypertensive Disorders of Pregnancy Using Cell-Free Fetal DNA, Cell-Free Total DNA, and Biochemical Markers

Early Prediction of Hypertensive Disorders of Pregnancy Using Cell-Free Fetal DNA, Cell-Free Total DNA, and Biochemical Markers

Multiple marker second trimester serum screening for pre-eclampsia

Screening models using multiple markers for early detection of late-onset preeclampsia in low-risk pregnancy

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