PP13 and PAPP-A in the First and Second Trimesters: Predictive Factors for Preeclampsia?

Narges Moslemi Zadeh,Farshad Naghshvar,Parand Gheshlaghi,Sara Ehetshami,Sepideh Peyvandi

doi:10.5402/2012/263871

Abstract

Background. Preeclampsia affects 5-6% of all pregnancies. Predictive factors of preeclampsia can be helpful in early diagnosis of this disease. In this study the predictive values of biochemical markers placenta protein 13 (PP13) and pregnancy-associated plasma protein A (PAPP-A) have been assessed in early diagnosis of preeclampsia. Methods. This case-control study was conducted on 1500 women who presented to a healthcare center of Sari, Iran, between 2010 and 2011. Blood samples were drawn in weeks 11–13 and 24–28 of pregnancy. Of them who developed preeclampsia were considered as case group. A control group consisted of similar women regarding mean age, body mass index (BMI), and pregnancy age. PAPP-A and PP13 serum levels were measured. Data were analyzed using proper statistical tests. Results. PAPP-A and PP13 serum levels were significantly lower in both the first and second trimesters in women who developed preeclampsia (P < 0.001). The cumulative value of all four variables with cut-off point of 238.5 has sensitivity, specificity of 91.0%, and undercurve surface of 0.968 which is the most diagnostic value for preeclampsia. Conclusion. It is possible to advantage measuring of PAPP-A and PP13 in the first and second trimesters especially their cumulative values in both trimesters for prediction of the incidence of preeclampsia.

Highlights

Preeclampsia is defined as systolic blood pressure equal to or more than 140 mmHg and diastolic blood pressure equal to or more than 90 mmHg associated with proteinuria equal to or more than 300 mg in 24 hr urine or 1+ result in dipstick test which occurs after weeks 20 of pregnancy [1]
Of 1500 pregnant women who were followed in this study, 100 women with preeclampsia were classified in case group and 100 other women with normal pregnancy with matched body mass index (BMI), age, and pregnancy age were recruited as control group
Of 100 women with preeclampsia 66 cases have mild preeclampsia while 34 cases have severe preeclampsia (Figure 1), the mean serum levels of measured markers in the first and second trimesters significantly differ between these two groups

Summary

Introduction

Preeclampsia is defined as systolic blood pressure equal to or more than 140 mmHg and diastolic blood pressure equal to or more than 90 mmHg associated with proteinuria equal to or more than 300 mg in 24 hr urine or 1+ result in dipstick test which occurs after weeks 20 of pregnancy [1]. Placenta protein 13 (PP13) is a dimer 32 k dalton protein which is produced by placenta and has role in implementation This protein has been attracted as a probable marker for early diagnosis of preeclampsia [3, 4]. Some studies have shown that measuring PP13 levels in the first trimester has predictive value. In this study the predictive values of biochemical markers placenta protein 13 (PP13) and pregnancy-associated plasma protein A (PAPP-A) have been assessed in early diagnosis of preeclampsia. PAPP-A and PP13 serum levels were significantly lower in both the first and second trimesters in women who developed preeclampsia (P < 0.001). It is possible to advantage measuring of PAPP-A and PP13 in the first and second trimesters especially their cumulative values in both trimesters for prediction of the incidence of preeclampsia

Methods

Results

Conclusion