Meta-analysis for the relationship between circulating pregnancy-associated plasma protein A and placenta accreta spectrum

Li, Yan; Meng, Yizi; Chi, Yang; Li, Ping; He, Jin

doi:10.1097/md.0000000000034473

Cited by 1 publication

(1 citation statement)

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“…The sensitivity and specificity of maternal serum alpha-fetoprotein in the diagnosis of placenta previa complicated by PAS were only 71% and 46%, respectively [23]. According to a meta-analysis, pregnant women with PAS have a high serum PAPP-A level in the first trimester [24,25], suggesting that this biomarker can be recommended for identifying the risk group for developing PAS. Several studies have shown that, compared to a normal pregnancy, the level of β-hCG in maternal blood serum increases in the first and second trimesters of pregnancy during PAS [23,26]; however, blood serum hCG levels are also associated with miscarriage, ectopic pregnancy, and fetal abnormalities [21].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Role of Cell-Free miRNAs in Identifying Placenta Accreta Spectrum during First-Trimester Screening

Timofeeva,

Fedorov,

Suhova

et al. 2024

IJMS

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Placenta accreta spectrum (PAS) is a severe complication of pregnancy associated with excessive invasion of cytotrophoblast cells at the sites of the endometrial–myometrial interface and the myometrium itself in cases of adherent (creta) and invasive (increta and percreta) forms, respectively. This leads to a high risk of massive blood loss, maternal hysterectomy, and preterm birth. Despite advancements in ultrasound protocols and found associations of alpha-fetoprotein, PAPP-A, hCG, PLGF, sFlt-1, IL-8, and IL-33 peripheral blood levels with PAS, there is a high need for an additional non-invasive test to improve the diagnostic accuracy and to select the real PAS from the suspected ones in the first-trimester screening. miRNA signatures of placental tissue, myometrium, and blood plasma from women with PAS in the third trimester of pregnancy, as well as miRNA profiles in exosomes from the blood serum of women in the first trimester with physiologically progressing pregnancy, complicated by PAS or pre-eclampsia, were obtained using deep sequencing. Two logistic regression models were constructed, both featuring statistically significant parameters related to the levels of miR-26a-5p, miR-17-5p, and miR-101-3p, quantified by real-time PCR in native blood serum. These models demonstrated 100% sensitivity in detecting PAS during the first pregnancy screening. These miRNAs were identified as specific markers for PAS, showing significant differences in their blood serum levels during the first trimester in the PAS group compared to those in physiological pregnancies, early- or late-onset pre-eclampsia groups. Furthermore, these miRNAs exhibited differential expression in the PAS placenta and/or myometrium in the third trimester and, according to data from the literature, control angiogenesis. Significant correlations were found between extracellular hsa-miR-101-3p and nuchal translucency thickness, hsa-miR-17-5p and uterine artery pulsatility index, and hsa-miR-26a-5p and hsa-miR-17-5p with PLGF. The developed test system for early non-invasive PAS diagnosis based on the blood serum level of extracellular miR-26a-5p, miR-17-5p, and miR-101-3p can serve as an auxiliary method for first-trimester screening of pregnant women, subject to validation with independent test samples.

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