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Abnormal analyte preeclampsia: do the second-trimester maternal serum analytes help differentiate preeclampsia subtypes?

Critchfield AS, Paulus JK, Farez R, Urato AC - J Perinatol (2013)

Bottom Line: Inhibin-A and maternal serum alpha fetoprotein were inversely correlated with newborn birth-weight percentile (-0.27, P=0.006; -0.35, P=0.00004) and delivery GA (r=-0.42, P<0.0001; r=-0.26, P=0.008) and positively correlated with pre-delivery aspartate aminotransferase (r=0.22, P=0.03; r=0.21, P=0.04) and lactate dehydrogenase (r=0.33, P=0.0007; r=0.29, P=0.004).A positive correlation was noted between both second-trimester beta human chorionic gonadotropin and estriol and maternal pre-delivery creatinine (0.28, P=0.004; 0.4, P<0.0001, respectively).Hundred percent of patients with ≥ 2 abnormal analytes delivered before 37 weeks gestation.

View Article: PubMed Central - PubMed

Affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA, USA.

ABSTRACT

Objective: To determine if serum screen analytes identify preeclamptic patients at risk for small-for-gestational age newborns, maternal laboratory abnormalities and preterm delivery (<37 weeks gestation).

Study design: Using a retrospective cohort of 102 preeclamptic patients, associations between serum screen analytes and newborn birth-weight percentile, gestational age (GA) at delivery and maternal pre-delivery laboratory abnormalities were evaluated using correlation coefficients and local polynomial regression.

Result: Inhibin-A and maternal serum alpha fetoprotein were inversely correlated with newborn birth-weight percentile (-0.27, P=0.006; -0.35, P=0.00004) and delivery GA (r=-0.42, P<0.0001; r=-0.26, P=0.008) and positively correlated with pre-delivery aspartate aminotransferase (r=0.22, P=0.03; r=0.21, P=0.04) and lactate dehydrogenase (r=0.33, P=0.0007; r=0.29, P=0.004). A positive correlation was noted between both second-trimester beta human chorionic gonadotropin and estriol and maternal pre-delivery creatinine (0.28, P=0.004; 0.4, P<0.0001, respectively). Hundred percent of patients with ≥ 2 abnormal analytes delivered before 37 weeks gestation.

Conclusion: Preeclamptic patients with abnormal serum screen analytes are more likely to have small-for-gestational age newborns, deliver preterm and have pre-delivery laboratory abnormalities.

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Related in: MedlinePlus

Birth-weight percentile (as calculated by Hadlock scale) plotted against gestational age (weeks) at delivery
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Figure 3: Birth-weight percentile (as calculated by Hadlock scale) plotted against gestational age (weeks) at delivery

Mentions: Individual serum screen analytes were plotted against both birth weight percentile and gestational age at delivery (Figures 1 and 2, respectively). Those fetuses with elevated Inhibin-A and MS-AFP were delivered at earlier gestational ages and had lower birth-weight percentiles. While this trend in birth-weight percentile was not seen with β-HCG, those patients with elevated β-HCG did deliver at earlier gestational ages (Figure 2). In addition, a clear association was seen between birth-weight percentile and gestational-age at delivery, with growth restricted fetuses being delivered at earlier gestational ages (Figure 3).


Abnormal analyte preeclampsia: do the second-trimester maternal serum analytes help differentiate preeclampsia subtypes?

Critchfield AS, Paulus JK, Farez R, Urato AC - J Perinatol (2013)

Birth-weight percentile (as calculated by Hadlock scale) plotted against gestational age (weeks) at delivery
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3760989&req=5

Figure 3: Birth-weight percentile (as calculated by Hadlock scale) plotted against gestational age (weeks) at delivery
Mentions: Individual serum screen analytes were plotted against both birth weight percentile and gestational age at delivery (Figures 1 and 2, respectively). Those fetuses with elevated Inhibin-A and MS-AFP were delivered at earlier gestational ages and had lower birth-weight percentiles. While this trend in birth-weight percentile was not seen with β-HCG, those patients with elevated β-HCG did deliver at earlier gestational ages (Figure 2). In addition, a clear association was seen between birth-weight percentile and gestational-age at delivery, with growth restricted fetuses being delivered at earlier gestational ages (Figure 3).

Bottom Line: Inhibin-A and maternal serum alpha fetoprotein were inversely correlated with newborn birth-weight percentile (-0.27, P=0.006; -0.35, P=0.00004) and delivery GA (r=-0.42, P<0.0001; r=-0.26, P=0.008) and positively correlated with pre-delivery aspartate aminotransferase (r=0.22, P=0.03; r=0.21, P=0.04) and lactate dehydrogenase (r=0.33, P=0.0007; r=0.29, P=0.004).A positive correlation was noted between both second-trimester beta human chorionic gonadotropin and estriol and maternal pre-delivery creatinine (0.28, P=0.004; 0.4, P<0.0001, respectively).Hundred percent of patients with ≥ 2 abnormal analytes delivered before 37 weeks gestation.

View Article: PubMed Central - PubMed

Affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA, USA.

ABSTRACT

Objective: To determine if serum screen analytes identify preeclamptic patients at risk for small-for-gestational age newborns, maternal laboratory abnormalities and preterm delivery (<37 weeks gestation).

Study design: Using a retrospective cohort of 102 preeclamptic patients, associations between serum screen analytes and newborn birth-weight percentile, gestational age (GA) at delivery and maternal pre-delivery laboratory abnormalities were evaluated using correlation coefficients and local polynomial regression.

Result: Inhibin-A and maternal serum alpha fetoprotein were inversely correlated with newborn birth-weight percentile (-0.27, P=0.006; -0.35, P=0.00004) and delivery GA (r=-0.42, P<0.0001; r=-0.26, P=0.008) and positively correlated with pre-delivery aspartate aminotransferase (r=0.22, P=0.03; r=0.21, P=0.04) and lactate dehydrogenase (r=0.33, P=0.0007; r=0.29, P=0.004). A positive correlation was noted between both second-trimester beta human chorionic gonadotropin and estriol and maternal pre-delivery creatinine (0.28, P=0.004; 0.4, P<0.0001, respectively). Hundred percent of patients with ≥ 2 abnormal analytes delivered before 37 weeks gestation.

Conclusion: Preeclamptic patients with abnormal serum screen analytes are more likely to have small-for-gestational age newborns, deliver preterm and have pre-delivery laboratory abnormalities.

Show MeSH
Related in: MedlinePlus