Papageorghiou Aris T, Prefumo Federico, Leslie Karin, Gaze David C, Collinson Paul O, Thilaganathan Baskaran
Fetal Medicine Unit, Academic Department of Clinical Developmental Sciences, 4th Floor, Lanesborough Wing, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK.
Hum Reprod. 2008 Apr;23(4):803-6. doi: 10.1093/humrep/den029. Epub 2008 Feb 16.
Ischemia-modified albumin (IMA), a protein elevated in cardiac ischemia, is also increased to supra-physiological levels in early normal pregnancy. This finding supports the hypothesis that normal trophoblast development is stimulated by a hypoxic intrauterine environment. The aim of this study was to examine whether first trimester IMA levels are further elevated with defective trophoblast development.
Prospective study of healthy women with singleton pregnancies undergoing nuchal translucency assessment at 11-14 weeks. First trimester maternal serum IMA concentrations in those subsequently developing pre-term pre-eclampsia (n = 19) were compared to randomly chosen controls with normal pregnancy outcome (n = 69).
Median first trimester serum IMA concentrations were significantly higher in women who subsequently developed pre-eclampsia (median 126.5 kU/L, interquartile range (IQR) 114.33-134.36 kU/L) when compared to those with normal pregnancy outcome (median 115.01 kU/L, IQR 102.29-124.81 kU/L, P = 0.02).
Maternal serum IMA levels are elevated in the first trimester in women with pre-eclampsia, a clinical manifestation of defective endovascular trophoblast development. This suggests that abnormally high intrauterine hypoxia and subsequent reperfusion oxidative damage may be associated with defective trophoblast development. First trimester serum IMA may be a potential biomarker for abnormal placental development.
缺血修饰白蛋白（IMA）是一种在心脏缺血时升高的蛋白质，在正常妊娠早期也会升高至超生理水平。这一发现支持了以下假设，即正常的滋养层发育受到子宫内缺氧环境的刺激。本研究的目的是探讨孕早期IMA水平是否会随着滋养层发育缺陷而进一步升高。
对在11至14周接受颈部透明带评估的单胎健康孕妇进行前瞻性研究。将随后发生早发型子痫前期的孕妇（n = 19）的孕早期母血清IMA浓度与随机选择的妊娠结局正常的对照组（n = 69）进行比较。
与妊娠结局正常的孕妇相比，随后发生子痫前期的孕妇孕早期血清IMA浓度中位数显著更高（中位数126.5 kU/L，四分位数间距（IQR）114.33 - 134.36 kU/L），而妊娠结局正常的孕妇中位数为115.01 kU/L，IQR为102.29 - 124.81 kU/L，P = 0.02）。
子痫前期孕妇孕早期母血清IMA水平升高，子痫前期是血管内滋养层发育缺陷的一种临床表现。这表明异常高的子宫内缺氧及随后的再灌注氧化损伤可能与滋养层发育缺陷有关。孕早期血清IMA可能是胎盘发育异常的潜在生物标志物。
