Abstract

BackgroundEarly detection of pregnancies at risk of complications, such as intrauterine growth restriction (IUGR) and preeclampsia (PE), is critical for improved monitoring and preventative treatment to optimize health outcomes. We predict that levels of placental-derived proteins circulating in maternal blood reflect placental gene expression, which is associated with placental DNA methylation (DNAm) profiles. As such, placental DNAm profiling may be useful to distinguish pregnancies at risk of developing complications and correlation between DNAm and protein levels in maternal blood may give further evidence for a protein’s use as a biomarker. However, few studies investigate all clinical parameters that may influence DNAm and/or protein expression, which can significantly affect the relationship between these measures.Results Candidate genes were chosen based on i) reported alterations of protein levels in maternal blood and ii) observed changes in placental DNAm (∆β > 0.05 and False Discovery Rate (FDR) <0.05) in pregnancies complicated by PE/IUGR. Fibronectin (FN1) enhancer DNAm and placental gene expression were inversely correlated (r = −0.88 p < 0.01). The same trend was observed between promoter DNAm and gene expression for INHBA and PAPPA, though not significant. INHBA and FN1 DNAm was associated with gestational–age corrected birth weight, while INHA levels were associated with fetal: placental weight ratio and FN1 level was associated with maternal body mass index (BMI).DNAm at the INHBA promoter in the term placenta was negatively correlated with second trimester maternal serum levels (r = −0.50 p = 0.01) and DNAm at the FN1 enhancer was negatively associated with third trimester maternal serum levels (r = −0.38, p = 0.009). However, a similar correlation was not found for PAPPA.ConclusionsThese results show that establishing a correlation between altered DNAm in the term placenta and altered maternal serum levels of the corresponding protein, is affected by a number of factors. Nonetheless, the correlation between placental DNAm of INHBA/FN1 and maternal serum INHA/FN1 levels indicate that DNAm may be a useful tool to identify novel biomarkers for adverse pregnancy outcomes in some cases.Electronic supplementary materialThe online version of this article (doi:10.1186/s12881-015-0257-z) contains supplementary material, which is available to authorized users.

Highlights

  • Detection of pregnancies at risk of complications, such as intrauterine growth restriction (IUGR) and preeclampsia (PE), is critical for improved monitoring and preventative treatment to optimize health outcomes

  • Previous studies have shown upregulation of both pregnancy associated plasma protein A (PAPPA) and INBHA in the placentas of pregnancies complicated by PE and IUGR [12, 14,15,16]

  • Several studies have reported DNA methylation (DNAm) alterations in placentas from pregnancies complicated by PE and/or IUGR [14, 17, 18]

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Summary

Introduction

Detection of pregnancies at risk of complications, such as intrauterine growth restriction (IUGR) and preeclampsia (PE), is critical for improved monitoring and preventative treatment to optimize health outcomes. Placental insufficiency is the inability of the placenta to provide an adequate supply of nutrients to the growing fetus This can lead to a number of pregnancy complications including intrauterine growth restriction (IUGR) [1] and preeclampsia (PE), a maternal hypertensive disorder, which manifests as maternal hypertension and proteinuria after 20 weeks (wks) gestation [2]. Placental-derived proteins may be released into the maternal circulation where they can be quantified and used to assess placental function during pregnancy [3,4,5,6] Such protein markers have been investigated for the prediction of PE and/or IUGR with varying success [7,8,9]. The ability to predict women at risk of late-onset PE (LOPE, diagnosis >34 wks) and IUGR is limited using these markers

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