Abstract

Objective To discuss the application of pregnancy-sociated plasma protein (PAPP)-A, disintegrin-metalloproteinase (ADAM) 12 in prenatal screening during first trimester. Methods A total of 1 609 samples which were collected from pregnant women receiving prenatal screening in the first trimester in Gansu Provincial Maternity and Child-Care Hospital from May 2010 to July 2012 were included into this study. Their age ranged from 18 to 45 years old, and gestational age ranged from 9 to 13+6 gestational weeks. Auto-DELFLA were used to test the levels of serum ADAM 12, PAPP-A and free β-human chorionic gonadotrophin(hCG), then the results were analyzed by LifeCycle 3.0 risk assessment software. Furthermore, the relationship between fetal risks [Down syndrome (DS), open neural tube defect (ONTD), trisomy 18 syndrome] and levels of ADAM12, PAPP-A, free β-hCG were detected. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Gansu Provincial Maternity and Child-Care Hospital. Informed consent was obtained from each participants' parents. Results Among the 1 609 samples, the levels of free β-hCG, PAPP-A and ADAM12 increased with gestational age. The related indexes of serum free β-hCG, PAPP-A and ADAM12 showed positive correlations with gestational weeks (r = 0.955 2, 0.993 3, 0.996 5 ; P<0.05). The results of linear regression analysis among serum free β-hCG, PAPP-A and ADAM12 showed strong positive correlation (free β-hCG vs. PAPP-A, r=0.949 0,P<0.05;free β-hCG vs. ADAM12, r=0.944 0, P<0.05; ADAM12 vs. PAPP-A, r = 0.977 0, P<0.05). In addition, of the 1 609 samples, eleven cases (0.68%) had chromosome abnormalities, including four cases of 45, XO (0.25%), three cases of DS (0.19%), two cases of neural tube defects (0.12%), one case of 18-trisomy syndrome (0.06%), one case of 13-trisomy syndrome (0.06%). The multiples of median (MoM) levels of serum PAPP-A and ADAM12 were lower than those of normal chromosome pregnant women. Conclusions Serum PAPP-A and ADAM12 could be used as indicators of prenatal screening for chromosomal abnormalities during the first trimester. Key words: Serum disintegrin-metalloproteinase 12; First trimester; Prenatal diagnosis

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