National Institute of Immunohaematology (ICMR), 13th Floor, KEM Hospital, Parel, Mumbai 400 012, India.
Surat Raktadan Kendra & Research Centre, Regional Blood Transfusion Centre, Surat 395 002, Gujarat, India.
Pregnancy Hypertens. 2019 Jul;17:20-27. doi: 10.1016/j.preghy.2019.04.006. Epub 2019 May 3.
To evaluate the combination of plasma activated endothelial microparticles (CD62e), serum Copeptin (CPP) and placental growth factor (PlGF) levels at 18-23 weeks of gestation for prediction of preeclampsia (PE) in primigravid women.
This was a nested case-control study from a prospective cohort of 1115 primigravid women attending antenatal care clinic. Plasma levels of CD62e and serum Copeptin, PlGF levels were measured by flow cytometry and ELISA, respectively. Data were presented as median (Interquartile range) and biomarker levels were compared between patients and controls using Mann-Whitney Test. Using binary logistic regression, predictive potential of a combination of biomarkers for PE prediction was determined.
Women who developed PE 41 (3.97%) showed significantly increased levels of plasma CD62e [799.33 (546.86-1249.29) versus 384.08 (245.03-576.00), p < 0.0001], serum Copeptin [303.42 (226.01-484.18) versus 207.24 (169.73-276.46), p < 0.0001] and reduced level of PlGF [238.38 (161.36-312.62) versus 947.21 (466.7-1428.56), p < 0.0001] compared to controls at 18-23 weeks of gestation. None of the marker showed statistically significant alteration in levels in fetal growth restriction (FGR) group 68 (6.58%) compared to controls. Using binary logistic regression analysis, AUC, Sensitivity, specificity, PLR, NLR, PPV, and NPV of combination of CD62e, Copeptin and PlGF for prediction of PE at 18-23 weeks of gestation was 0.969, 92.3%, 90.3%, 9.73, 0.08, 79.17%, and 96.94%, respectively.
At 18-23 weeks, Combination of CD62e microparticles, copeptin, and PlGF levels can effectively identify women at risk of developing PE later in gestation.
评估孕 18-23 周血浆激活的内皮微颗粒（CD62e）、血清 copeptin（CPP）和胎盘生长因子（PlGF）水平的联合检测在初产妇子痫前期（PE）预测中的作用。
这是一项前瞻性队列中 1115 例初产妇的巢式病例对照研究。采用流式细胞术和 ELISA 法分别检测血浆 CD62e 和血清 copeptin、PlGF 水平。数据以中位数（四分位距）表示，采用 Mann-Whitney 检验比较患者和对照组之间的生物标志物水平。采用二元逻辑回归确定生物标志物联合对 PE 预测的预测潜力。
41 例（3.97%）发生 PE 的患者血浆 CD62e[799.33（546.86-1249.29）比 384.08（245.03-576.00），p<0.0001]、血清 copeptin[303.42（226.01-484.18）比 207.24（169.73-276.46），p<0.0001]水平显著升高，PlGF[238.38（161.36-312.62）比 947.21（466.7-1428.56），p<0.0001]水平降低，与孕 18-23 周的对照组相比。在 68 例（6.58%）胎儿生长受限（FGR）组中，没有一个标志物的水平显示出统计学上的显著变化。采用二元逻辑回归分析，CD62e、copeptin 和 PlGF 联合检测在孕 18-23 周预测 PE 的 AUC、敏感性、特异性、PLR、NLR、PPV 和 NPV 分别为 0.969、92.3%、90.3%、9.73、0.08、79.17%和 96.94%。
在孕 18-23 周时，CD62e 微颗粒、copeptin 和 PlGF 水平的联合检测可有效识别妊娠晚期发生 PE 的高危妇女。
