Greeley Elizabeth T, Rochelson Burton, Krantz David A, Xue Xiangying, Carmichael Jonathan B, Ashour Sarah, Woo Seunghyun, Augustine Stephanie, Metz Christine N
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Center for Maternal Fetal Medicine, Annapolis, MD, USA.
Reprod Sci. 2020 Jan;27(1):355-363. doi: 10.1007/s43032-019-00032-5. Epub 2020 Jan 6.
To determine if circulating levels of maternal syndecan-1, a part of the endothelial glycocalyx, change over gestational weeks 11-13 and if first trimester serum syndecan-1 levels are aberrant in women with adverse pregnancy outcomes vs. controls. Dried blood samples from 300 randomly selected women (100 each from gestational weeks 11, 12, and 13) who delivered at Northwell Health were assessed for syndecan-1 levels. Subjects were segregated by gestational age and maternal weight at the time of blood draw. Gestational age-specific medians were determined by linear regression of median syndecan-1 values vs. gestational age. Multiples of the median (MoMs) = syndecan-1/respective gestational age-specific regressed median. After determining a normal range, we performed a case-control study. Cases (n = 119) were singleton pregnancies with preeclampsia or fetal growth restriction who delivered at 20-36 6/7 weeks with 1st trimester conventional aneuploidy screens; 2 controls (n = 238) per case were identified and assessed. Syndecan-1 levels were determined by ELISA. Data were reported as MoMs and analyzed based on Wilcoxon rank-sum test and Fisher's exact test. A progressive and significant increase in median circulating Sdc1 concentrations was observed from gestational weeks 11-13 (p < 0.001). There was no significant difference in median syndecan-1 MoM values among cases and controls (p = 0.22). However, a subgroup of cases (17.6%) had extreme syndecan-1 values (≤ 0.5MoM) vs. 6.7% of controls (p = 0.003, OR = 3.0). Serum syndecan-1 concentrations significantly increase during gestational weeks 11-13. Extremely low 1st trimester serum syndecan-1 values are associated with an increased risk of adverse pregnancy outcome.
为了确定作为内皮糖萼一部分的母体Syndecan-1的循环水平在孕11至13周期间是否发生变化，以及与对照组相比，妊娠早期血清Syndecan-1水平在妊娠结局不良的女性中是否异常。对在诺斯韦尔健康中心分娩的300名随机选择的女性（孕11、12和13周各100名）的干血样本进行Syndecan-1水平评估。根据采血时的孕周和母体体重对受试者进行分类。通过Syndecan-1中位数与孕周的线性回归确定特定孕周的中位数。中位数倍数（MoMs）=Syndecan-1/各自特定孕周回归中位数。确定正常范围后，我们进行了一项病例对照研究。病例组（n = 119）为单胎妊娠，患有先兆子痫或胎儿生长受限，在孕20至36 6/7周分娩，并进行了孕早期常规非整倍体筛查；每个病例确定并评估2名对照组（n = 238）。通过酶联免疫吸附测定法测定Syndecan-1水平。数据以MoMs报告，并基于Wilcoxon秩和检验和Fisher精确检验进行分析。在孕11至13周期间，观察到循环Sdc1浓度中位数呈渐进性显著增加（p < 0.001）。病例组和对照组的Syndecan-1 MoM中位数无显著差异（p = 0.22）。然而，病例组中有一个亚组（17.6%）的Syndecan-1值极低（≤0.5MoM），而对照组为6.7%（p = 0.003，OR = 3.0）。孕11至13周期间血清Syndecan-1浓度显著增加。妊娠早期血清Syndecan-1值极低与不良妊娠结局风险增加相关。
