Abstract
In normal pregnancies, a hypoxic intrauterine environment seems necessary for the early trophoblast development. In this context, mother's serum levels of ischemia modified albumin (IMA) are elevated reflecting the oxidative stress associated with placental development. The aim of this study is to evaluate serum levels of IMA and pregnancy associated plasma protein-A (PAPP-A) in mothers bearing small-for-gestational age (SGA) fetuses compared to normal pregnancies. A prospective study was performed between June 2013 and May 2014. Serum total albumin, IMA and PAPP-A concentrations were determined in 81 pregnant women in 3 different periods: 1st trimester, 2nd trimester and in the postpartum. Two groups of subjects were identified: group 1) mothers bearing appropriate-for-gestational-age fetuses (AGA) and group 2) mothers bearing SGA fetuses. Serum total albumin and IMA concentrations were determined in 198 non-pregnant women as controls. Serum IMA concentrations increase during the gestation. IMA/Albumin serum levels in the 1st trimester were significantly higher in subjects of group 2 (p < 0.05), whereas values of serum PAPP-A MoM were significantly lower (p < 0.05). Elevated IMA serum levels together with low levels of PAPP-A were detected in the 1st trimester in mothers bearing SGA fetuses and that may reflect early placental changes occurring before clinical manifestation of SGA.
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