Maternal venous SHARP1 levels in preeclampsia

First trimester SHARP1 and second-trimester uterine artery Doppler to predict preeclampsia

OBJECTIVES

The objective of this study was to identify the predictive value of the first-trimester serum SHARP1 level and the second-trimester uterine artery Doppler in singleton pregnancy for the prediction of preeclampsia.

METHODS

A prospective study including singleton pregnancy presenting at an antenatal clinic, King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University from 2019-March 2020 was conducted. Serum SHARP1 was collected at the gestational age (GA) of 11-13+6 weeks, and transabdominal uterine artery Doppler ultrasound was performed at GA of 18-24 weeks. Serum SHARP1 level and uterine artery pulsatility index (PI) were combined to calculate the predictive value for preeclampsia detection.

RESULTS

288 pregnant women were enrolled in the first trimester, but only 249 participants completed the study. Thirteen patients had preeclampsia (5.2%), which three cases (1.2%) had early-onset preeclampsia. The median serum SHARP1 level in the first trimester of pregnant women with preeclampsia was lower than the normal pregnancy group (1392 pg/ml vs. 1941 pg/ml, p = 0.046). The second-trimester uterine artery PI and prevalence of early diastolic notching were higher in the preeclampsia group than in the normal pregnancy group (p = 0.029 and p = 0.001, respectively). When the first-trimester serum SHARP1 level is combined with the second-trimester uterine artery PI, the sensitivity, specificity, PPV, and NPV for preeclampsia prediction were 84.6%, 47.5%, 8.2%, and 98.3%, respectively.

CONCLUSIONS

This study demonstrated that serum SHARP1 level in the first trimester combined with the uterine artery PI in the second trimester had good sensitivity to predict preeclampsia.

Maternal serum split and hairy-related protein 1 in preeclampsia versus normal pregnancy

OBJECTIVE

The primary objective was to compare maternal serum split and hairy related protein-1 (SHARP1) in preeclamptic women versus normal pregnant women. The secondary objectives were to compare maternal and neonatal outcomes between preeclampsia and normal pregnant women.

METHODS

This cross-sectional analytic study included 75 preeclamptic pregnant women and 75 normal pregnant women at Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital between March 2018 and May 2019. Blood was collected into nonheparinized tubes. Blood samples were centrifuged and stored at -80 °C until assayed. Maternal serum SHARP1 levels were measured by enzyme-linked immunosorbent assays. Maternal and neonatal outcomes were recorded.

RESULTS

Median serum SHARP1 level in preeclampsia was significantly higher than in normal pregnancy (5.2 vs. 3.7 ng/mL, p = .007). Preeclamptic women had a higher rate of cesarean section than normal pregnant women (68% vs. 32%, p < .001). Preeclamptic women had lower neonatal birth weight than normal pregnant women (2,546.1 ± 766.3 vs 2,884.5 ± 479.9, p = .001). Neonatal complications were higher in preeclamptic women than normal pregnant women (40% vs. 17.3%, p = .002).

CONCLUSIONS

Serum SHARP1 in preeclampsia was significantly higher than in normal pregnancy.

Serum SHARP1 and uterine artery Doppler for the prediction of preeclampsia

The aim of this study was to identify the value of serum SHARP1 levels and Doppler of the uterine artery in singleton pregnancy at 11–13⁺⁶ weeks for predicting preeclampsia. A prospective observational study was conducted in pregnant women at 11–13⁺⁶ weeks of pregnancy who had antenatal care at King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand, between January 2017 and January 2018. Serum SHARP1 measurement and transabdominal Doppler of the uterine artery were performed. The predictive values of these tests were determined. Data were obtained from 405 pregnant women. Thirty-five women had preeclampsia (8.6%), and six of these had early-onset preeclampsia (1.5%). Preeclamptic women had significantly lower serum SHARP1 levels than pregnant women without preeclampsia (3.6 ng/ml vs 4.7 ng/ml, p < 0.01). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of serum SHARP1 levels of less than 3.89 ng/ml for predicting preeclampsia were 77.1%, 72.7%, 21.1% and 97.1%, respectively. For uterine artery Doppler, the sensitivity, specificity, PPV and NPV of the mean pulsatility index (PI) > 95^th percentile for predicting preeclampsia were 5.7%, 95.4%, 10.5% and 91.5%, respectively. For the combination of serum SHARP1 levels with a cutoff value of less than 3.89 ng/ml and a mean PI > 95^th percentile, the sensitivity, specificity, PPV and NPV were 77.1%, 70.3%, 19.7% and 97.0%, respectively. This study demonstrated that serum SHARP1 is a promising biomarker for predicting preeclampsia in the first trimester.