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DLK1: A Novel Biomarker of Placental Insufficiency in Stillbirth and Live Birth.
Page, Jessica M; Allshouse, Amanda A; Gaffney, Jessica E; Roberts, Victoria H J; Thorsten, Vanessa; Gibbins, Karen J; Dudley, Donald J; Saade, George; Goldenberg, Robert L; Stoll, Barbara J; Hogue, Carol J; Bukowski, Radek; Parker, Corette; Conway, Deborah; Reddy, Uma M; Varner, Michael W; Frias, Antonio E; Silver, Robert M.
Afiliación
  • Page JM; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah.
  • Allshouse AA; Division of Maternal-Fetal Medicine, Intermountain Health Care, Murray, Utah.
  • Gaffney JE; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah.
  • Roberts VHJ; Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center Oregon Health and Science University, Portland, Oregon.
  • Thorsten V; Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center Oregon Health and Science University, Portland, Oregon.
  • Gibbins KJ; RTI International, Research Triangle Park, North Carolina.
  • Dudley DJ; Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon.
  • Saade G; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia.
  • Goldenberg RL; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston.
  • Stoll BJ; Department of Obstetrics and Gynecology, Columbia University, New York, New York.
  • Hogue CJ; Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas.
  • Bukowski R; Rollins School of Public Health, Emory University, Atlanta, Georgia.
  • Parker C; Department of Women's Health, Dell Medical School, University of Texas at Austin, Austin, Texas.
  • Conway D; RTI International, Research Triangle Park, North Carolina.
  • Reddy UM; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
  • Varner MW; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, Connecticut.
  • Frias AE; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah.
  • Silver RM; Division of Maternal-Fetal Medicine, Intermountain Health Care, Murray, Utah.
Am J Perinatol ; 2022 Aug 22.
Article en En | MEDLINE | ID: mdl-35709732
OBJECTIVE: Delta-like homolog 1 (DLK1) is a growth factor that is reduced in maternal sera in pregnancies with small for gestational age neonates. We sought to determine if DLK1 is associated with stillbirth (SB), with and without placental insufficiency. STUDY DESIGN: A nested case-control study was performed using maternal sera from a multicenter case-control study of SB and live birth (LB). SB and LB were stratified as placental insufficiency cases (small for gestational age <5% or circulatory lesions on placental histopathology) or normal placenta controls (appropriate for gestational age and no circulatory lesions). Enzyme-linked immunosorbent assay (ELISA) was used to measure DLK1. The mean difference in DLK1 was compared on the log scale in an adjusted linear regression model with pairwise differences, stratified by term/preterm deliveries among DLK1 results in the quantifiable range. In exploratory analysis, geometric means were compared among all data and the proportion of "low DLK1" (less than the median value for gestational age) was compared between groups and modeled using linear and logistic regression, respectively. RESULTS: Overall, 234 SB and 234 LB were analyzed; 246 DLK1 values were quantifiable within the standard curve. Pairwise comparisons of case and control DLK1 geometric means showed no significant differences between groups. In exploratory analysis of all data, adjusted analysis revealed a significant difference for the LB comparison only (SB: 71.9 vs. 99.1 pg/mL, p = 0.097; LB: 37.6 vs. 98.1 pg/mL, p = 0.005). In exploratory analysis of "low DLK1," there was a significant difference between the odds ratio of having "low DLK1" between preterm cases and controls for both SB and LB. There were no significant differences in geometric means nor "low DLK1" between SB and LB. CONCLUSION: In exploratory analysis, more placental insufficiency cases in preterm SB and LB had "low DLK1." However, low DLK1 levels were not associated with SB. KEY POINTS: · Maternally circulating DLK1 is correlated with placental insufficiency.. · Maternally circulating DLK1 is not correlated with SB.. · DLK1 is a promising marker for placental insufficiency..

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Am J Perinatol Año: 2022 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Am J Perinatol Año: 2022 Tipo del documento: Article