1
|
Guzmán YN, Uriel M, Ramírez AP, Romero XC. Uterine Artery Pulsatility Index as a Pre-eclampsia Predictor in the 3 Trimesters in Women with Singleton Pregnancies. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:904-910. [PMID: 34933383 PMCID: PMC10183923 DOI: 10.1055/s-0041-1740273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To evaluate the mean uterine artery pulsatility index (UtAPI) in each trimester of pregnancy as a predictor of early or late pre-eclampsia (PE) in Colombian pregnant women. METHODS The UtAPI was measured in singleton pregnancies in each trimester. Uterine artery pulsatility index as predictor of PE was evaluated by odds ratio (OR), receiver operating characteristic (ROC) curves, and Kaplan-Meier diagram. RESULTS Analysis in the 1st and 3rd trimester showed that abnormal UtAPI was associated with early PE (OR: 5.99: 95% confidence interval [CI]: 1.64-21.13; and OR: 10.32; 95%CI: 2.75-42.49, respectively). Sensitivity and specificity were 71.4 and 79.6%, respectively, for developing PE (area under the curve [AUC]: 0.922). The Kaplan-Meier curve showed that a UtAPI of 0.76 (95%CI: 0.58-1.0) in the 1st trimester was associated with early PE, and a UtAPI of 0.73 (95%CI: 0.55-0.97) in the 3rd trimester was associated with late PE. CONCLUSION Uterine arteries proved to be a useful predictor tool in the 1st and 3rd trimesters for early PE and in the 3rd trimester for late PE in a pregnant population with high prevalence of PE.
Collapse
Affiliation(s)
- Yuly Natalia Guzmán
- Universidad El Bosque, El Bosque Research Group of Maternal Fetal Medicine and Gynecology, Bogotá, Colombia
| | - Montserrat Uriel
- Universidad El Bosque, El Bosque Research Group of Maternal Fetal Medicine and Gynecology, Ecodiagnóstico El Bosque SAS, Los Cobos Medical Center, Bogotá, Colombia
| | - Alexandra Porras Ramírez
- Universidad El Bosque, Research Group Community Medicine and Collective Health, Los Cobos Medical Center, Bogotá, Colombia
| | - Ximena Carolina Romero
- Universidad El Bosque, El Bosque Research Group of Maternal Fetal Medicine and Gynecology, Ecodiagnóstico El Bosque SAS, Los Cobos Medical Center, Bogotá, Colombia
| |
Collapse
|
2
|
Hirashima C, Ohkuchi A, Sasaki K, Takahashi K, Suzuki H, Matsubara S, Matsuda Y. Low placental growth factor levels and high soluble endoglin levels at 26-31 weeks of gestation precede light placenta with and without relatively heavy infant, respectively: A retrospective cohort study. J Obstet Gynaecol Res 2021; 47:1040-1051. [PMID: 33401341 DOI: 10.1111/jog.14636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/19/2020] [Accepted: 12/17/2020] [Indexed: 11/29/2022]
Abstract
AIM Our aim was to examine whether serum levels of placental growth factor (PlGF) and soluble endoglin (sEng) at 19-25 and 26-31 weeks of gestation were associated with the occurrence of the 9-block categorization of placenta weight (PW) and fetal/placenta ratio (F/P ratio). METHODS We performed a retrospective cohort study in 1391 women with singleton pregnancy. Serum levels of PlGF and sEng were measured by enzyme immunosorbent assay. A light placenta was defined as PW ZS < -1.28 SD. Based on the PW (light, normal, and heavy) and F/P ratio (relatively heavy, balanced growth, and relatively small), 9-block categorization were performed. Multivariable logistic regression analyses were performed. RESULTS Low PlGF at 26-31 weeks was an independent risk factor for the birth of infants belonging to Block A (light placenta and relatively heavy infant), after adjusting for prepregnancy body mass index and serum levels of sEng. High sEng at 26-31 weeks was an independent risk factor for the birth of infants belonging to Block D (light placenta and balanced growth of infant), after adjusting for past history of either preeclampsia or gestational hypertension, high pulsatility index of uterine artery flow velocity waveforms in the second trimester, and serum level of PlGF. CONCLUSIONS Low PlGF levels at 26-31 weeks of gestation may precede a light placenta and relatively heavy infant (Block A), and high sEng levels at 26-31 weeks of gestation may precede a light placenta and balanced growth of infant (Block D).
Collapse
Affiliation(s)
- Chikako Hirashima
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Akihide Ohkuchi
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kemal Sasaki
- Department of Food and Health Sciences, Jissen Women's University, Tokyo, Japan
| | - Kayo Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Hirotada Suzuki
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Shigeki Matsubara
- Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yoshio Matsuda
- Department of Obstetrics and Gynecology, Japan Community Health Care Organization (JCHO), Mishima General Hospital, Mishima-shi, Japan
| |
Collapse
|
3
|
Sebastian A, Raj TJS, Yenuberi H, Job V, Varuhghese S, L J, Regi A. Angiogenic factors and uterine artery Doppler in predicting preeclampsia and associated adverse outcomes in a tertiary hospital in south India. Pregnancy Hypertens 2019; 16:26-30. [PMID: 31056155 DOI: 10.1016/j.preghy.2019.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/22/2019] [Accepted: 01/28/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Ajit Sebastian
- Department of Gynecologic Oncology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - T J Simi Raj
- Department of Obstetrics and Gynecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Hilda Yenuberi
- Department of Obstetrics and Gynecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
| | - Victoria Job
- Department of Clinical Biochemistry, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Santosh Varuhghese
- Department of Nephrology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Jayaseelan L
- Department of Biostatistics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Annie Regi
- Department of Obstetrics and Gynecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| |
Collapse
|
4
|
Serum soluble LIGHT in the early third trimester as a novel biomarker for predicting late-onset preeclampsia. Pregnancy Hypertens 2018; 14:174-176. [PMID: 30527108 DOI: 10.1016/j.preghy.2018.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 09/28/2018] [Accepted: 10/12/2018] [Indexed: 11/21/2022]
Abstract
Our aim was to evaluate whether serum levels of soluble LIGHT (sLIGHT) at 27-31 weeks can predict the later occurrence of gestational hypertension (GH), late-onset preeclampsia (PE), and early-onset PE. Mean blood pressure (MBP), soluble fma-like tyrosine kinase 1/placental growth factor (sFlt-1/PlGF) ratio at 27-31 weeks, and sLIGHT at 27-31 weeks were independent risk factors for late-onset PE. The combination of the three risk factors improved sensitivity with a false-positive rate of 10% (MBP: 60%, log10(sFlt-1/PlGF): 45%, sLIGHT: 35%, combination: 75%). Serum sLIGHT in the early third trimester may be a novel biomarker for predicting late-onset PE.
Collapse
|
5
|
Galectin-1 as a novel risk factor for both gestational hypertension and preeclampsia, specifially its expression at a low level in the second trimester and a high level after onset. Hypertens Res 2017; 41:45-52. [PMID: 28978981 DOI: 10.1038/hr.2017.85] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 04/10/2017] [Accepted: 05/07/2017] [Indexed: 12/18/2022]
Abstract
Our aim was to evaluate whether the serum level of galectin-1 (Gal-1) at 18-24 and 27-31 weeks of gestation is a risk factor for predicting the later occurrence of not only preeclampsia (PE) but also gestational hypertension (GH). We measured serum levels of soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), and Gal-1 using an enzyme-linked immunosorbent assay in 81 and 73 normal pregnant women, 22 and 16 women with a later onset of GH, and 37 and 29 women with a later onset of PE at 18-24 and 27-31 weeks, respectively. We also measured Gal-1 in 33 women with GH and 78 women with PE after the onset. The levels of Gal-1 after the onset of GH, late-onset PE (onset at ⩾34 weeks), and early-onset PE (onset at <34 weeks) were significantly higher than those in normal pregnant women at 27-31 weeks. However, the low levels of Gal-1 (<8.1 ng ml-1) at 18-24 weeks, but not at 27-31 weeks, predicted the later occurrence of not only early-onset PE and late-onset PE but also GH. The low level of Gal-1 at 18-24 weeks was an independent risk factor for the later occurrence of GH and PE, after adjusting for the effects of a high BP and increased sFlt-1/PlGF ratio at 18-24 weeks. In conclusion, the serum level of Gal-1 is a novel risk factor for both GH and PE, specifically its expression at a low level in the second trimester and a high level after onset.
Collapse
|
6
|
Abuyaman O, Torring N, Obeid R, Nexo E. First trimester serum levels of the soluble transcobalamin receptor, holo-transcobalamin, and total transcobalamin in relation to preeclampsia risk. Scandinavian Journal of Clinical and Laboratory Investigation 2016; 76:641-644. [PMID: 27700208 DOI: 10.1080/00365513.2016.1230885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Human placenta expresses CD320, a receptor that ensures the uptake of holo-transcobalamin (holoTC). Soluble CD320 (sCD320) is present in the circulation and its concentration increases during pregnancy. AIMS To investigate a possible association of sCD320, holoTC and total transcobalamin (TC) with the risk of subsequent preeclampsia using serum samples from asymptomatic first trimester pregnant women. Moreover, we aimed to establish reference intervals of the aforementioned biomarkers for first trimester pregnant women who remained healthy throughout pregnancy. STUDY DESIGN This study was a retrospective case-control study that we performed on biobank serum samples. Cases (n = 50) and controls (n = 198) (matched for gestational age and date of sample collection) were asymptomatic women in early pregnancy [median (range) gestational age = 10 (8-12) weeks]. Cases developed preeclampsia while the controls remained normotensive throughout pregnancy. We measured the serum concentration of sCD320, holoTC, and total TC by using in-house ELISA methods. RESULTS First trimester median concentrations of sCD320, holoTC and total TC were not significantly different between cases and controls. The odd ratio for developing preeclampsia based on exposure to low or high levels of sCD320, holoTC or total TC at first trimester was not significant. The reference intervals (2.5-97.5% percentiles (median)) derived from the controls were 50-170 (90) pmol\L for sCD320, 20-140 (70) pmol\L for holoTC and 560-1300 (810) pmol\L for total TC. CONCLUSIONS The risk of preeclampsia is not predicted by first trimester serum concentrations of sCD320, holoTC or total TC. The first trimester reference intervals for the three parameters is reported.
Collapse
Affiliation(s)
- Omar Abuyaman
- a Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark
| | - Niels Torring
- a Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark
| | - Rima Obeid
- b Aarhus Institute for Advanced Studies, Aarhus University , Aarhus , Denmark
| | - Ebba Nexo
- a Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark
| |
Collapse
|
7
|
Li L, Zheng Y, Zhu Y, Li J. Serum biomarkers combined with uterine artery Doppler in prediction of preeclampsia. Exp Ther Med 2016; 12:2515-2520. [PMID: 27698752 PMCID: PMC5038468 DOI: 10.3892/etm.2016.3625] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/18/2016] [Indexed: 12/20/2022] Open
Abstract
First-trimester screening may be a major advantage over a second-trimester approach since it opens prospects for early and more efficient interventions. The aim of the current study was to evaluate whether the measurement of maternal serum inhibin A, activin A and placental growth factor (PlGF) at three to four months gestation with the second-trimester uterine artery pulsatility index (PI) are useful in predicting preeclampsia in a group of nulliparous women. All the patients also underwent uterine artery Doppler examination to measure the PI at 22–24 weeks gestation. Inhibin A, activin A and PlGF were measured using an ELISA by an examiner who was blinded to the pregnancy outcome. Thirty-eight cases with preeclampsia and 100 controls were analyzed. Second-trimester uterine artery PI and marker levels were expressed as multiples of the median (MoM). The uterine artery PI was increased in pregnancies with preeclampsia compared with controls. In pregnancies that developed preeclampsia, the uterine artery PI was increased (1.61±0.047 vs. 1.02±0.049, P<0.001), as was the level of inhibin A (1.72±0.023 vs. 1.03±0.063, P<0.001) and the level of activin A (1.68±0.38 vs. 1.06±0.42, P<0.001) compared with the controls. In contrast, the level of PlGF was decreased in pregnancies that developed preeclampsia compared with the controls (0.69±0.23 vs. 1.00±0.26, P<0.001). A combination of activin A, PlGF and uterine artery PI gave an AUC of 0.915 (95% CI, 0.812–0.928; P<0.001) with a sensitivity of 91% at a specificity of 82%. In our study, we demonstrated that both serum inhibin A and activin A levels were increased, while the PlGF level was decreased in the early second-trimester in women who developed preeclampsia.
Collapse
Affiliation(s)
- Lijie Li
- Department of Obstetrics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China
| | - Yanmei Zheng
- Department of Obstetrics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China
| | - Ying Zhu
- Department of Obstetrics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China
| | - Jianchun Li
- Department of Ultrasonic Diagnosis, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China
| |
Collapse
|
8
|
Nagayama S, Ohkuchi A, Shirasuna K, Takahashi K, Suzuki H, Hirashima C, Sakata A, Nishimura S, Takahashi M, Matsubara S. The Frequency of Peripheral Blood CD4 +FoxP3 + Regulatory T Cells in Women With Pre-eclampsia and Those With High-risk Factors for Pre-eclampsia. Hypertens Pregnancy 2015; 34:443-455. [PMID: 26362262 DOI: 10.3109/10641955.2015.1065884] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We compared the frequency of peripheral blood Treg cells in women with pre-eclampsia (PE) and in those without, and investigated whether the frequency of Treg cells in women with high-risk factor for PE changed during pregnancy. METHODS We examined the frequency of CD4+FoxP3+ Treg cells in the peripheral blood using flow cytometry. Eleven women with PE and 10 women without PE (controls) were included. Every control had any risk factors for PE, such as high blood pressure, bilateral notching or a past history of PE or gestational hypertension. Blood sampling was conducted 1-3 times in the controls. RESULTS No significant differences were observed in the frequency of Treg cells between women with PE and the controls [mean ± SE (%): 5.74 ± 0.91 versus 5.48 ± 0.94, p = 0.843]. In five controls with serial sampling, the frequency of Treg cells significantly decreased from 5.83 ± 1.20 to 2.99 ± 0.54 (p = 0.046) (week of the first sampling to that of the last sampling [mean ± SD]: 21.5 ± 1.6 weeks to 31.2 ± 2.5 weeks). CONCLUSION The frequency of Treg cells in women with PE was almost identical to that in the controls. The frequency of Treg cells in the controls was reduced by half from the second trimester to the third trimester. These results suggested that the levels of Treg cells in a high-risk pregnant cohort were decreased to those in women with PE in the third trimester irrespective of the occurrence of PE.
Collapse
Affiliation(s)
- Shiho Nagayama
- a Department of Obstetrics and Gynecology , Jichi Medical University School of Medicine , Tochigi , Japan
| | - Akihide Ohkuchi
- a Department of Obstetrics and Gynecology , Jichi Medical University School of Medicine , Tochigi , Japan
| | - Koumei Shirasuna
- b Division of Inflammation Research , Center for Molecular Medicine, Jichi Medical University, Shimotsuke , Tochigi , Japan .,c Laboratory of Animal Reproduction, Department of Agriculture , Tokyo University of Agriculture , Atsugi , Kanagawa , Japan , and
| | - Kayo Takahashi
- a Department of Obstetrics and Gynecology , Jichi Medical University School of Medicine , Tochigi , Japan
| | - Hirotada Suzuki
- a Department of Obstetrics and Gynecology , Jichi Medical University School of Medicine , Tochigi , Japan
| | - Chikako Hirashima
- a Department of Obstetrics and Gynecology , Jichi Medical University School of Medicine , Tochigi , Japan
| | - Asuka Sakata
- d Division of Cell and Molecular Medicine, Center for Molecular Medicine , Jichi Medical University , Tochigi , Japan
| | - Satoshi Nishimura
- d Division of Cell and Molecular Medicine, Center for Molecular Medicine , Jichi Medical University , Tochigi , Japan
| | - Masafumi Takahashi
- b Division of Inflammation Research , Center for Molecular Medicine, Jichi Medical University, Shimotsuke , Tochigi , Japan
| | - Shigeki Matsubara
- a Department of Obstetrics and Gynecology , Jichi Medical University School of Medicine , Tochigi , Japan
| |
Collapse
|
9
|
Ohkuchi A, Hirashima C, Takahashi K, Shirasuna K, Suzuki H, Ariga H, Kobayashi M, Hirose N, Matsubara S, Suzuki M. A trio of risk factors for the onset of preeclampsia in the second and early third trimesters. Pregnancy Hypertens 2014; 4:224-30. [DOI: 10.1016/j.preghy.2014.04.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 03/10/2014] [Accepted: 04/06/2014] [Indexed: 11/28/2022]
|