Journal
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY
Volume 205, Issue -, Pages 153-157Publisher
ELSEVIER
DOI: 10.1016/j.ejogrb.2016.08.034
Keywords
Pre-eclampsia; Biochemical makers; Uterine artery pulsatility index; Ductus venosus pulsatility Index; First and/or second trimester screening; Neutrophil gelatinase-associated lipocalin
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Funding
- Masters Program: Research on Woman's Reproduction of Athens Medical School
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Objective: To determine the performance of maternal characteristics, Doppler and a set of biochemical markers for pre-eclampsia (PE) screening at 11 + 0 to 13 + 6 and 20 + 1 to 25 + 6 weeks' gestation. Study design: Prospectively enrolled women at 11 + 0 to 13 + 6 and 20 + 1 to 25 + 6 weeks. Maternal characteristics, uterine artery pulsatility index (UtA-PI), ductus venosus pulsatility index (DV-PI) and serum biomarkers including pregnancy associated plasma protein - A (PAPP-A), placental growth factor (PIGF), soluble fms-like tyrosine kinase 1 (sFlt-1), s-Flt-1/PLGF ratio, asymmetric dimethylarginine (ADMA), matrix metalloproteinase 9 (MMP-9), neutrophil gelatinase-associated lipocalin (NGAL) and MMP-9/NGAL complex were recorded. Results: Combination of NGAL and BMI in a logistic regression model detected 70% of PE in the first trimester (p = 0.001). Including UtA-PI and DV-PI in the model sensitivity reached 77.8% with 96.6% specificity (p = 0.004). Combination of second trimester NGAL and s-Flt-1/PLGF ratio yield specificity 100% (p = 0.001). Combination of second trimester UtA-PI with first trimester NGAL, BMI and age detected 80% of PE with specificity 91.9% (p = 0.001). Conclusion: Combination of NGAL, maternal characteristics and Doppler parameters in the first and/or second trimester can detect a consistent number of PE pregnancies. NGAL is a potent new biomarker for the prediction of preeclampsia. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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