Limits...
Activin A and follistatin as biomarkers for ectopic pregnancy and missed abortion.

Daponte A, Deligeoroglou E, Garas A, Pournaras S, Hadjichristodoulou C, Messinis IE - Dis. Markers (2013)

Bottom Line: We assessed whether a single serum measurement of the two physiological antagonists at 6-8 weeks gestation could differentiate ectopic pregnancies (EP) or missed abortions (MA) from healthy intrauterine pregnancies (IUP). activin A concentrations were significantly lower in women with EP (n = 30, median value of 264 pg/mL) and women with MA (n = 30, median value of 350 pg/mL) compared to IUP (n = 33, median value of 788 pg/mL); P < 0.001.In EP, activin A did not correlate with beta HCG levels.The present findings support the thesis that activin A or FS could be considered promising biomarkers for the discrimination between an IUP and a failed pregnancy (MA or EP).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Biopolis, Larissa, Greece.

ABSTRACT
Activin A as a predictor of pregnancy failure has been the focus of heated debate, but the value of a combined activin A and follistatin (FS) measurement in serum to predict pregnancy failure has not been reported yet. We assessed whether a single serum measurement of the two physiological antagonists at 6-8 weeks gestation could differentiate ectopic pregnancies (EP) or missed abortions (MA) from healthy intrauterine pregnancies (IUP). activin A concentrations were significantly lower in women with EP (n = 30, median value of 264 pg/mL) and women with MA (n = 30, median value of 350 pg/mL) compared to IUP (n = 33, median value of 788 pg/mL); P < 0.001. At a threshold value of 505 pg/mL, activin A had 87.9% sensitivity and 100% specificity and negative predictive value of 0.974 for discriminating an ectopic pregnancy from viable pregnancies. FS was able to discriminate IUP from EP (ROC curve P < 0.001) as was their ratio (ROC curve P = 0.008), but was unable to discriminate a MA from an EP. In EP, activin A did not correlate with beta HCG levels. The present findings support the thesis that activin A or FS could be considered promising biomarkers for the discrimination between an IUP and a failed pregnancy (MA or EP).

Show MeSH

Related in: MedlinePlus

Receiver Operating Characteristics (ROC) curve analyses for the diagnostic accuracy of activin A, follistatin, and activin A/follistatin ratio values to discriminate a viable intrauterine pregnancy from an ectopic pregnancy. *Normal versus ectopic.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3814079&req=5

fig2: Receiver Operating Characteristics (ROC) curve analyses for the diagnostic accuracy of activin A, follistatin, and activin A/follistatin ratio values to discriminate a viable intrauterine pregnancy from an ectopic pregnancy. *Normal versus ectopic.

Mentions: Analysis of variance was conducted in order to perform orthogonal contrasts (Helmert contrasts) comparing IUP to MA and EP, as well as MA to EP regarding activin A, FS, and their ratio. The optimal cut-off points for sensitivity and specificity were calculated by Receiver Operating Characteristics (ROC) curve analyses. According to the design of this study, the area under the curve (AUC) depicts the probability that the single value of activin A, FS, or their ratio of a randomly selected patient with a normal pregnancy illustrated in Figure 2 (see the following) will exceed that of a single value of a randomly selected patient with an abnormal pregnancy (EP or MA).


Activin A and follistatin as biomarkers for ectopic pregnancy and missed abortion.

Daponte A, Deligeoroglou E, Garas A, Pournaras S, Hadjichristodoulou C, Messinis IE - Dis. Markers (2013)

Receiver Operating Characteristics (ROC) curve analyses for the diagnostic accuracy of activin A, follistatin, and activin A/follistatin ratio values to discriminate a viable intrauterine pregnancy from an ectopic pregnancy. *Normal versus ectopic.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3814079&req=5

fig2: Receiver Operating Characteristics (ROC) curve analyses for the diagnostic accuracy of activin A, follistatin, and activin A/follistatin ratio values to discriminate a viable intrauterine pregnancy from an ectopic pregnancy. *Normal versus ectopic.
Mentions: Analysis of variance was conducted in order to perform orthogonal contrasts (Helmert contrasts) comparing IUP to MA and EP, as well as MA to EP regarding activin A, FS, and their ratio. The optimal cut-off points for sensitivity and specificity were calculated by Receiver Operating Characteristics (ROC) curve analyses. According to the design of this study, the area under the curve (AUC) depicts the probability that the single value of activin A, FS, or their ratio of a randomly selected patient with a normal pregnancy illustrated in Figure 2 (see the following) will exceed that of a single value of a randomly selected patient with an abnormal pregnancy (EP or MA).

Bottom Line: We assessed whether a single serum measurement of the two physiological antagonists at 6-8 weeks gestation could differentiate ectopic pregnancies (EP) or missed abortions (MA) from healthy intrauterine pregnancies (IUP). activin A concentrations were significantly lower in women with EP (n = 30, median value of 264 pg/mL) and women with MA (n = 30, median value of 350 pg/mL) compared to IUP (n = 33, median value of 788 pg/mL); P < 0.001.In EP, activin A did not correlate with beta HCG levels.The present findings support the thesis that activin A or FS could be considered promising biomarkers for the discrimination between an IUP and a failed pregnancy (MA or EP).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Biopolis, Larissa, Greece.

ABSTRACT
Activin A as a predictor of pregnancy failure has been the focus of heated debate, but the value of a combined activin A and follistatin (FS) measurement in serum to predict pregnancy failure has not been reported yet. We assessed whether a single serum measurement of the two physiological antagonists at 6-8 weeks gestation could differentiate ectopic pregnancies (EP) or missed abortions (MA) from healthy intrauterine pregnancies (IUP). activin A concentrations were significantly lower in women with EP (n = 30, median value of 264 pg/mL) and women with MA (n = 30, median value of 350 pg/mL) compared to IUP (n = 33, median value of 788 pg/mL); P < 0.001. At a threshold value of 505 pg/mL, activin A had 87.9% sensitivity and 100% specificity and negative predictive value of 0.974 for discriminating an ectopic pregnancy from viable pregnancies. FS was able to discriminate IUP from EP (ROC curve P < 0.001) as was their ratio (ROC curve P = 0.008), but was unable to discriminate a MA from an EP. In EP, activin A did not correlate with beta HCG levels. The present findings support the thesis that activin A or FS could be considered promising biomarkers for the discrimination between an IUP and a failed pregnancy (MA or EP).

Show MeSH
Related in: MedlinePlus