Associations between serum placental leucine aminopeptidase and pregnancy outcomes

Objective: To investigate the association between serum concentrations of placental leucine aminopeptidase (P-LAP) and hypertensive disorders in pregnancy (HDP), gestational diabetes mellitus (GDM), and perinatal mortality. Methods: In a prospective study, women with singleton pregnancies and affected by HDP, GDM, or fetal death, and those who were healthy, were enrolled at Shenzhen Seventh People's Hospital, Shenzhen, China, between January 2014 and July 2015. Serum P-LAP concentrations at delivery/fetal death were compared among the groups. The predictive value of serum P-LAP levels in fetal death was evaluated. Results: Serum P-LAP concentrations were (mean +/- SEM) 74.02 +/- 8.45 U/L in the HDP group (n=38), 72.57 +/- 12.03 U/L in the GDM group (n=35), and 3.76 +/- 3.02 U/L in the fetal death group (n=14), all of which were significantly lower than the mean concentration of 107.11 +/- 30.68 U/L in the control group (n=30; P=0.031, P=0.042, and P<0.001, respectively). On the basis of the receiver operating characteristic curve, low serum P-LAP levels had high sensitivity and specificity for predicting fetal death (100% and 78.9%, respectively, for a serum P-LAP cutoff of 47.07 U/L). Conclusion: Serum P-LAP levels were reduced among patients with HDP and GDM, and extremely low among patients affected by fetal death. Serum P-LAP is potentially a viable predictor of fetal death. (C) 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.