Belovic Dušica Kocijančić, Plešinac Snežana, Dotlić Jelena, Radojević Ana Savić, Akšam Slavica, Cvjetićanin Mirjana Marjanović, Kocijančić Aleksandar
Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia.
Medical Faculty, University of Belgrade, Belgrade, Serbia.
J Med Biochem. 2019 Mar 1;38(1):71-82. doi: 10.2478/jomb-2018-0001. eCollection 2019 Mar.
Gestational hypertension (GH) and pre eclampsia (PE) are the most common gestational complications. Several placental biochemical markers are used to predict GH/PE, but with conflicting results.
The study aim was to estimate the biochemical markers' ability to predict hypertensive disorders in pregnancy. On the first ultrasonographic examination, 104 healthy pregnant women were recruited. At the regular pregnancy check-ups, BMI, blood pressure, occurrence of gestational hypertension (early or late onset), preeclampsia, eclampsia and other complications were recorded. Serum concentrations (in multiples of median - MoM) of human chorionic gonadotropin (HCG) and pregnancyassociated plasma protein A (PAPPA) were measured from the 11th to 14th gestational week, while HCG, alpha feto protein (AFP), estriol and inhibin were determined between the 16th and 19th gestational week.
Hypertensive disorders throughout pregnancy were diagnosed in 20.2% women. Early-onset GH was registered in 7 and PE in 6 patients, while 14 had late-onset GH and 10 additional women PE. There were no significant differences (p≥0.05) in biochemical markers concentrations between women with and without GH/PE. PAPPA levels in the first and HCG in the second trimester correlated with early and late GH/PE. Moreover, higher AFP concentrations were registered in women with preeclampsia signs/symptoms. According to ROC analysis, AFP>1.05 MoM properly identified 80% of GH/PE cases. Obtained models imply that HCG, PAPPA and AFP should be used for GH/PE prediction.
Biochemical markers HCG, PAPPA and AFP could be useful in predicting gestational hypertension and preeclampsia. However, different markers should be used for early and late onset GH/PE.
妊娠期高血压（GH）和子痫前期（PE）是最常见的妊娠并发症。几种胎盘生化标志物被用于预测GH/PE，但结果相互矛盾。
本研究旨在评估生化标志物预测妊娠高血压疾病的能力。在首次超声检查时，招募了104名健康孕妇。在定期产检时，记录孕妇的体重指数（BMI）、血压、妊娠期高血压（早发型或晚发型）、子痫前期、子痫及其他并发症的发生情况。在妊娠第11至14周测量血清人绒毛膜促性腺激素（HCG）和妊娠相关血浆蛋白A（PAPPA）的浓度（以中位数倍数 - MoM表示），而在妊娠第16至19周测定HCG、甲胎蛋白（AFP）、雌三醇和抑制素。
整个孕期有20.2%的女性被诊断为高血压疾病。7例患者为早发型GH，6例为PE，14例为晚发型GH，另有10例女性为PE。有或无GH/PE的女性之间生化标志物浓度无显著差异（p≥0.05）。孕早期的PAPPA水平和孕中期的HCG水平与早发型和晚发型GH/PE相关。此外，有子痫前期体征/症状的女性AFP浓度较高。根据ROC分析，AFP>1.05 MoM能正确识别80%的GH/PE病例。得到的模型表明，HCG、PAPPA和AFP可用于预测GH/PE。
生化标志物HCG、PAPPA和AFP可用于预测妊娠期高血压和子痫前期。然而，早发型和晚发型GH/PE应使用不同的标志物。
