Prediction of the preeclampsia: a view of biochemical markers

Authors

  • Mehmet Sühha Bostancı Sakarya University, Faculty of Medicine Department of Obsterics and Gynecology, Sakarya, Turkey
  • Merih Bayram Gazi University, Faculty of Medicine Department of Obsterics and Gynecology, Ankara, Turkey
  • Arif Serhan Cevrioğlu Sakarya University, Faculty of Medicine Department of Obsterics and Gynecology, Sakarya, Turkey
  • Selçuk Özden Sakarya University, Faculty of Medicine Department of Obsterics and Gynecology, Sakarya, Turkey
  • Nermin Akdemir Sakarya University, Faculty of Medicine Department of Obsterics and Gynecology, Sakarya, Turkey.
  • Sedat Umur Sakarya University, Faculty of Medicine Department of Obsterics and Gynecology, Sakarya, Turkey

DOI:

https://doi.org/10.7175/rhc.v4i4.699

Keywords:

Preeclampsia, Biochemical markers, Pregnancy-associated placental protein A

Abstract

Preeclampsia is a diverse, multiorgan group of related disease processes that occurs in up to 5%-8% of pregnancies after 20 weeks’ gestation and it is one of the leading causes of maternal and fetal morbidity and mortality. Many molecular mechanisms are contributed to the pathogenesis of preeclampsia. Although it is unknown whether the mechanisms act independently or have synergistic effects. This review describes review of primary papers investigating blood based biomarker such as PAP-A, Inhibin A, sFlt1, and PP13 in general and first trimester biochemical markers and combinations of them specifically for preeclampsia.

References

Wagner SJ, Barac S, Garovic VD. Hypertensive pregnancy disorders: current concepts. J Clin Hypertens 2007; 9: 560-6; http://dx.doi.org/10.1111/j.1524-6175.2007.06695.x

Trupin LS, Simon LP, Eskenazi B. Change in paternity: a risk factor for preeclampsia in multiparas. Epidemiology 1996; 7: 240-4; http://dx.doi.org/10.1097/00001648-199605000-00004

Steinberg G, Khankin EV, Karumanchi KM. Angiogenic factors and preeclampsia. Thrombosis Research 2009; 123: S93-9; http://dx.doi.org/10.1016/S0049-3848(09)70020-9

Venkatesha S, Toporsian M, Lam C. et al. Soluble endoglin contributes to the pathogenesis of preeclampsia. Nature Medicine 2006; 12: 642-9; http://dx.doi.org/10.1038/nm1429

Roberts JM, Cooper DW. Pathogenesis and genetics of pre-eclampsia. The Lancet 2001; 357: 53-6; http://dx.doi.org/10.1016/S0140-6736(00)03577-7

Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science 2005; 308: 1592-4; http://dx.doi.org/10.1126/science.1111726

Saito S, Shiozaki A, Nakashima A, et al. The role of the immune system in preeclampsia. Mol Aspects Med 2007; 28: 192-9; http://dx.doi.org/10.1016/j.mam.2007.02.006

Redman CW, Sargent IL. Immunology of pre-eclampsia. Am J Reprod Immunol 2010; 63: 534-43; http://dx.doi.org/10.1111/j.1600-0897.2010.00831.x

Bayram M, Bostancı MS,Celtemen B, et al. Maternal Inflammatory Response in Severe Preeclamptic and Preeclamptic Pregnancies. J Clin Gynecol Obstet 2012; 1: 40-5

Chaouat G, Tranchot Diallo J, Volumenie JL, et al. Immune suppression and Th1/Th2 balance in pregnancy revisited: a (very) personal tribute to Tom Wegmann. Am J Reprod Immunol 1997; 37: 427-34; http://dx.doi.org/10.1111/j.1600-0897.1997.tb00255.x

Kalkunte S, Lai Z, Norris WE, et al. Novel approaches for mechanistic understanding and predicting preeclampsia. J Reprod Immunol 2009; 83: 134-8; http://dx.doi.org/10.1016/j.jri.2009.08.006

Westergaard JG, Teisner B, Grudzinskas JG. Serum PAPP-A in normal pregnancy: relationship to fetal and maternal characteristics. Arch Gynecol 1983; 233: 211e5

Kagan KO, Wright D, Valencia C, et al. Screening for trisomies 21, 18 and 13 by maternal age, fetal nuchal translucency, fetal heart rate, free beta-hCG and pregnancy-associated plasma protein-A. Hum Reprod 2008; 23: 1968-75; http://dx.doi.org/10.1093/humrep/den224

Goetzinger KR, Singla A, Gerkowicz S, et al. Predicting the risk of pre-eclampsia between 11 and 13 weeks’ gestation by combining maternal characteristics and serum analytes, PAPP-A and free beta-hCG. Prenat Diagn 2010; 30: 1138-42; http://dx.doi.org/10.1002/pd.2627

D’Anna R, Baviera G, Giordano D, et al. First trimester serum PAPP-A and NGAL in the prediction of late-onset pre-eclampsia. Prenat Diagn 2009; 29: 1066-8; http://dx.doi.org/10.1002/pd.2339

Ong CY, Liao AW, Spencer K, et al. First trimester maternal serum free beta human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complications. BJOG 2000; 107: 1265-70; http://dx.doi.org/10.1111/j.1471-0528.2000.tb11618.x

Smith GC, Stenhouse EJ, Crossley JA, et al. Early pregnancy levels of pregnancy-associated plasma protein A and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab 2002; 87: 1762-7; http://dx.doi.org/10.1210/jc.87.4.1762

Bersinger NA, Odegard RA. Second- and third-trimester serum levels of placental proteins in preeclampsia and small-forgestational age pregnancies. Acta Obstet Gynecol Scand 2004; 83: 37-45; http://dx.doi.org/10.1111/j.1600-0412.2004.00277.x

Spencer K, Yu CK, Cowans NJ, et al. Prediction of pregnancy complications by first-trimester maternal serum PAPP-A and free beta-hCG and with second-trimester uterine artery Doppler. Prenat Diagn 2005; 25: 949-53; http://dx.doi.org/10.1002/pd.1251

Spencer K, Cowans NJ, Nicolaides KH. Low levels of maternal serum PAPP-A in the first trimester and the risk of pre-eclampsia. Prenat Diagn 2008; 28: 7-10; http://dx.doi.org/10.1002/pd.1890

Dugoff L, Hobbins JC, Malone FD, et al. First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: a population-based screening study (the FASTER Trial). Am J Obstet Gynecol 2004; 191: 1446-51; http://dx.doi.org/10.1016/j.ajog.2004.06.052

Canini S, Prefumo F, Pastorino D, et al. Association between birth weight and first-trimester free beta-human chorionic gonadotropin and pregnancy-associated plasma protein A. Fertil Steril 2008; 89: 174-8; http://dx.doi.org/10.1016/j.fertnstert.2007.02.024

Muttukrishna S, Knight PG, Groome NP, et al. Activin A and inhibin A as possible endocrine markers for preeclampsia. Lancet 1997; 349: 1285-8; http://dx.doi.org/10.1016/S0140-6736(96)09264-1

Salomon LJ, Benattar C, Audibert F, et al. Severe preeclampsia is associated with high inhibin A levels and normal leptin levels at 7–13 weeks into pregnancy. Am J Obstet Gynecol 2003; 189: 1517-22; http://dx.doi.org/10.1016/S0002-9378(03)00902-5

Roes EM, Gaytant MA, Thomas CM, et al. First trimester inhibin-A concentrations and later development of preeclampsia. Acta Obstet Gynecol Scand 2004; 83: 117; http://dx.doi.org/10.1111/j.1600-0412.2004.00140.x

Diesch CH, Holzgreve W, Hahn S, et al. Comparison of activin A and cell-free fetal DNA levels in maternal plasma from patients at high risk for preeclampsia. Prenat Diagn 2006; 26: 1267-70; http://dx.doi.org/10.1002/pd.1606

Zwahlen M, Gerber S, Bersinger NA. First trimester markers for preeclampsia: placental vs. non-placental protein serum levels. Gynecol Obstet Invest 2007; 63: 15-21; http://dx.doi.org/10.1159/000094672

Muttukrishna S, North RA, Morris J, et al. Serum inhibin A and activin A are elevated prior to the onset of pre-eclampsia. Hum Reprod 2000; 15: 1640-5; http://dx.doi.org/10.1093/humrep/15.7.1640

Sibai BM, Koch MA, Freire S, et al. Serum inhibin A and angiogenic factor levels in pregnancies with previous preeclampsia and/or chronic hypertension: are they useful markers for prediction of subsequent preeclampsia? Am J Obstet Gynecol 2008; 199: 268-9; http://dx.doi.org/10.1016/j.ajog.2008.06.071

Spencer K, Yu CK, Savvidou M, et al. Prediction of pre-eclampsia by uterine artery Doppler ultrasonography and maternal serum pregnancy-associated plasma protein-A, free beta-human chorionic gonadotropin, activin A and inhibin A at 22 + 0 to 24 + 6 weeks’ gestation. Ultrasound Obstet Gynecol 2006; 27: 658-63; http://dx.doi.org/10.1002/uog.2676

Than NG, Pick E, Bellyei S, et al. Functional analyses of placental protein 13/galectin-13. Eur J Biochem 2004; 271: 1065-78

Visegrady B, Than NG, Kilar F, et al. Homology modelling and molecular dynamics studies of human placental tissue protein 13 (galectin-13). Protein Eng 2001; 14: 875-80

Akolekar R, Syngelaki A, Beta J, et al. Maternal serum placental protein 13 at 11-13 weeks of gestation in preeclampsia. Prenat Diagn 2009; 29: 1103-8; http://dx.doi.org/10.1002/pd.2375

Khalil A, Cowans NJ, Spencer K, et al. First trimester markers for the prediction of pre-eclampsia in women with a-priori high risk. Ultrasound Obstet Gynecol 2010; 35: 671-9; http://dx.doi.org/10.1002/uog.7559

Nicolaides KH, Bindra R, Turan OM, et al. A novel approach to first-trimester screening for early pre-eclampsia combining serum PP-13 and Doppler ultrasound. Ultrasound Obstet Gynecol 2006; 27: 13-7

Stamatopoulou A, Cowans NJ, Matwejew E, et al. Placental Protein-13 and pregnancy-associated plasma Protein-A as first trimester screening markers for hypertensive disorders and small for gestational age outcomes. Hypertens Pregnancy 2011; 30: 384-95; http://dx.doi.org/10.3109/10641955.2010.484081

Polliotti BM, Fry AG, Saller DN, et al. Second-trimester maternal serum placental growth factor and vascular endothelial growth factor for predicting severe, early onset preeclampsia. Obstet Gynecol 2003; 101: 1266-74; http://dx.doi.org/10.1016/S0029-7844(03)00338-7

Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med 2004; 350: 672-83; http://dx.doi.org/10.1056/NEJMoa031884

Tidwell SC, Ho HN, Chiu WH, et al. Low maternal serum levels of placenta growth factor as an antecedent of clinical preeclampsia. Am J Obstet Gynecol 2001; 184: 1267-72; http://dx.doi.org/10.1067/mob.2001.113129

Thadhani R, Mutter WP, Wolf M, et al. First trimester placental growth factor and soluble fms-like tyrosine kinase 1 and risk for preeclampsia. J Clin Endocrinol Metab 2004; 89: 770-5; http://dx.doi.org/10.1210/jc.2003-031244

Vatten LJ, Eskild A, Nilsen TI, et al. Changes in circulating level of angiogenic factors from the first to second trimester as predictors of preeclampsia. Am J Obstet Gynecol 2007; 196: 239-46; http://dx.doi.org/10.1016/j.ajog.2006.10.909

Erez O, Romero R, Espinoza J, et al. The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age. J Matern Fetal Neonatal Med 2008; 21: 279-87; http://dx.doi.org/10.1080/14767050802034545

Kusanovic JP, Romero R, Chaiworapongsa T, et al. A prospective cohort study of the value of maternal plasma concentrations of angiogenic and anti-angiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia. J Matern Fetal Neonatal Med 2009; 22: 1021-38; http://dx.doi.org/10.3109/14767050902994754

Taylor RN, Grimwood J, Taylor RS, et al. Longitudinal serum concentrations of placental growth factor: evidence for abnormal placental angiogenesis in pathologic pregnancies. Am J Obstet Gynecol 2003; 188: 177-82; http://dx.doi.org/10.1067/mob.2003.111

Ong CY, Liao AW, Cacho AM, et al. First trimester maternal serum levels of placenta growth factor as predictor of preeclampsia and fetal growth restriction. Obstet Gynecol 2001; 98: 608-11; http://dx.doi.org/10.1016/S0029-7844(01)01528-9

Smith GC, Crossley JA, Aitken DA, et al. Circulating angiogenic factors in early pregnancy and the risk of preeclampsia, intrauterine growth restriction, spontaneous preterm birth, and stillbirth. Obstet Gynecol 2007; 109: 1316-24; http://dx.doi.org/10.1097/01.AOG.0000265804.09161.0d

Tjoa ML, van Vugt JM, Mulders MA, et al. Plasma placenta growth factor levels in midtrimester pregnancies. Obstet Gynecol 2001; 98: 600-7; http://dx.doi.org/10.1016/S0029-7844(01)01497-1

Su YN, Lee CN, Cheng WF, et al. Decreased maternal serum placenta growth factor in early second trimester and preeclampsia. Obstet Gynecol 2001; 97: 898-904; http://dx.doi.org/10.1016/S0029-7844(01)01341-2

Chappell LC, Seed PT, Briley A, et al. A longitudinal study of biochemical variables in women at risk of preeclampsia. Am J Obstet Gynecol 2002; 187: 127-36; http://dx.doi.org/10.1067/mob.2002.122969

Krauss T, Pauer HU, Augustin HG. Prospective analysis of placenta growth factor (PlGF) concentrations in the plasma of women with normal pregnancy and pregnancies complicated by preeclampsia. Hypertens Pregnancy 2004; 23: 101-11; http://dx.doi.org/10.1081/PRG-120028286

Kim SY, Ryu HM, Yang JH, et al. Increased sFlt-1 to PlGF ratio in women who subsequently develop preeclampsia. J Korean Med Sci 2007; 22: 873-7; http://dx.doi.org/10.3346/jkms.2007.22.5.873

Espinoza J, Romero R, Nien JK, et al. Identification of patients at risk for early onset and/or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor. Am J Obstet Gynecol 2007; 196: 326.e1-13; http://dx.doi.org/10.1016/j.ajog.2006.11.002

Akolekar R, de Cruz J, Foidart JM, Munaut C, Nicolaides KH. Maternal plasma soluble fms-like tyrosine kinase-1 and free vascular endothelial growth factor at 11 to 13 weeks of gestation in preeclampsia. Prenat Diagn 2010; 30: 191-7; http://dx.doi.org/10.1002/pd.2433

De Vivo A, Baviera G, Giordano D, Todarello G, Corrado F, D’Anna R. Endoglin, PlGF and sFlt-1 as markers for predicting pre-eclampsia. Acta Obstet Gynecol Scand 2008; 87: 837-42; http://dx.doi.org/10.1080/00016340802253759

Unal ER, Robinson CJ, Johnson DD, et al. Second-trimester angiogenic factors as biomarkers for future-onset preeclampsia. Am J Obstet Gynecol 2007; 197: 211-4; http://dx.doi.org/10.1016/j.ajog.2007.05.022

Romero R, Nien JK, Espinoza J, et al. A longitudinal study of angiogenic (placental growth factor) and antiangiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small for gestational age neonate. J Matern Fetal Neonatal Med 2008; 21: 9-23; http://dx.doi.org/10.1080/14767050701830480

Kim SY, Ryu HM, Yang JH, et al. Increased sFlt-1 to PlGF ratio in women who subsequently develop preeclampsia. J Korean Med Sci 2007; 22: 873-7; http://dx.doi.org/10.3346/jkms.2007.22.5.873

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Published

2013-10-21

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Narrative reviews