Maternal & Fetal Heath Research Centre, Manchester Academic Health Science Centre, University of Manchester, Central Manchester NHS Trust, Manchester, United Kingdom
Pronota, Zwijnaarde, Belgium.
Reprod Sci. 2015 Feb;22(2):235-41. doi: 10.1177/1933719114537713. Epub 2014 Jun 4.
An overrepresentation of adverse pregnancy outcomes has been observed in pregnancies associated with a male fetus. We investigated the association between fetal gender and candidate biomarkers for preeclampsia. Proteins were quantified in samples taken at 20 weeks from women recruited to the SCreening fOr Pregnancy Endpoints (SCOPE) study (preeclampsia n = 150; no preeclampsia n = 450). In contrast to placental growth factor, soluble endoglin, and insulin-like growth factor acid labile subunit, levels of metallopeptidase domain 12 (ADAM12) at 20 weeks were dependent on fetal gender in pregnancies complicated by preeclampsia, for male (n = 73) fetuses the multiples of the median (MoM; interquartile range [IQR] 1.1-1.5) was 1.3, whereas for female fetuses (n = 75) MoM was 1.1 (1.0-1.3); P < .01. Prediction of preeclampsia using ADAM12 levels was improved for pregnancies associated with a male fetus (area under receiver-operator curve [AUC] 0.73 [95% confidence interval [CI] 0.67-0.80]) than that of a female fetus (AUC 0.62 [0.55-0.70]); P = .03. The data presented here fit a contemporary hypothesis that there is a difference between the genders in response to an adverse maternal environment and suggest that an alteration in ADAM12 may reflect an altered placental response in pregnancies subsequently complicated by preeclampsia.
已有研究观察到,与男性胎儿相关的妊娠中不良妊娠结局的发生率更高。我们研究了胎儿性别与子痫前期候选生物标志物之间的关系。我们在 20 周时,从参加 SCreening fOr Pregnancy Endpoints(SCOPE)研究的女性(子痫前期患者 n = 150;无子痫前期患者 n = 450)中采集样本,定量检测了蛋白水平。与胎盘生长因子、可溶性内皮糖蛋白和胰岛素样生长因子酸不稳定亚基不同,在伴有子痫前期的妊娠中,20 周时金属肽酶结构域 12(ADAM12)的水平取决于胎儿性别,男性(n = 73)胎儿的倍数中位数(MoM;四分位距 [IQR] 1.1-1.5)为 1.3,而女性胎儿(n = 75)MoM 为 1.1(1.0-1.3);P <.01。使用 ADAM12 水平预测子痫前期,对于与男性胎儿相关的妊娠,其曲线下面积(AUC)为 0.73(95%置信区间 [CI] 0.67-0.80),优于女性胎儿(AUC 0.62 [0.55-0.70]);P =.03。这里呈现的数据符合一种现代假说,即女性对不良母体环境的反应存在性别差异,并表明 ADAM12 的改变可能反映了随后子痫前期妊娠中胎盘反应的改变。