Combination of first trimester serum afamin levels and three-dimensional placental bed vascularization as a possible screening method to detect women at-risk for adverse pregnancy complications like pre-eclampsia and gestational diabetes mellitus in low-risk pregnancies.
Placenta
; 62: 9-15, 2018 02.
Article
em En
| MEDLINE
| ID: mdl-29405972
ABSTRACT
OBJECTIVE:
Aim of the study was to assess the correlation of first trimester serum afamin levels with three-dimensional placental bed vascularization in pregnant women and its prognostic value for predicting pre-eclampsia and future fetal and maternal complications during pregnancy.METHODS:
In this nested case-control study all pregnant women registered for delivery during a period of 3 years were routinely screened in the first trimester. Serum afamin levels were assessed in 764 women and correlated to 5 pregnancy outcome groups gestational hypertension (nâ¯=â¯76), pre-eclampsia (nâ¯=â¯33), intrauterine growth restriction (nâ¯=â¯91), pre-term birth (nâ¯=â¯39), gestational diabetes mellitus (nâ¯=â¯170); In addition, measurements of first trimester myometrial vascularization index were performed and, in combination with afamin tested as a possible screening method to detect women at-risk for the development of adverse complications in low-risk pregnancies at the time of the first trimester.RESULTS:
The results showed significantly higher serum afamin levels in women with pre-eclampsia (P<.05) and gestational diabetes mellitus (P<.05) compared to healthy pregnant women. There was no significant difference in serum afamin levels between all other pregnancy outcome groups and healthy controls. In women developing pre-eclampsia during pregnancy, afamin (ORâ¯=â¯1.0197, Pâ¯<â¯.05) and myometrial vascular index (ORâ¯=â¯0.9235, Pâ¯<â¯.001) were verified to have a significant prognostic value. Detection of pre-eclampsia in first trimester screening by a combination of afamin and myometrial vascular index performed best (AUCâ¯=â¯0.818).DISCUSSION:
Hence, first trimester screening for pre-eclampsia could be provided by a combination of afamin and placental bed vascularization. Moreover, the combination of first trimester serum afamin levels with BMI could provide a possible screening for gestational diabetes mellitus.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Placenta
/
Pré-Eclâmpsia
/
Glicoproteínas
/
Proteínas de Transporte
/
Diabetes Gestacional
/
Neovascularização Patológica
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Placenta
Ano de publicação:
2018
Tipo de documento:
Article