Hromadnikova Ilona, Kotlabova Katerina, Krofta Ladislav
Department of Molecular Biology and Cell Pathology, Third Faculty of Medicine, Charles University, Prague, Czechia.
Institute for the Care of the Mother and Child, Third Faculty of Medicine, Charles University, Prague, Czechia.
Front Med (Lausanne). 2024 Dec 3;11:1469855. doi: 10.3389/fmed.2024.1469855. eCollection 2024.
Placenta previa is the abnormal implantation of the placenta into the lower segment of the uterus, is associated with adverse maternal and fetal outcomes such as placenta accreta spectrum disorders, antepartum and postpartum hemorrhage, fetal growth restriction, prematurity, stillbirth and neonatal death, thrombophlebitis, and septicemia. The aim of the study was to assess retrospectively how the later onset of placenta previa affects the microRNA expression profile in the whole peripheral blood during the first trimester of gestation.
Regarding the occurrence of the association between aberrant microRNA expression profiles at early stages of gestation and later onset of various pregnancy-related complications, we selected for the study pregnancies developing placenta previa as the only pregnancy-related disorder. In total, 24 singleton pregnancies diagnosed with placenta previa that underwent first-trimester prenatal screening and delivered on-site within the period November 2012-May 2018 were included in the study. Overall, 80 normal pregnancies that delivered appropriate-for-gestational age newborns after completing 37 weeks of gestation were selected as the control group based on the equality of the length of biological sample storage.
Downregulation of multiple microRNAs (miR-20b-5p, miR-24-3p, miR-26a-5p, miR-92a-3p, miR-103a-3p, miR-130b-3p, miR-133a-3p, miR-145-5p, miR-146a-5p, miR-155-5p, miR-181a-5p, miR-195-5p, miR-210-3p, miR-342-3p, and miR-574-3p) was observed in pregnancies destined to develop placenta previa. The combination of seven microRNAs (miR-130b-3p, miR-145-5p, miR-155-5p, miR-181a-5p, miR-210-3p, miR-342-3p, and miR-574-3p) showed the highest accuracy (AUC 0.937, < 0.001, 100.0% sensitivity, 83.75% specificity) to differentiate, at early stages of gestation, between pregnancies with a normal course of gestation and those with placenta previa diagnosed in the second half of pregnancy. Overall, 75% of pregnancies destined to develop placenta previa were correctly identified at 10.0% FPR.
Consecutive large-scale analyses must be performed to verify the reliability of the proposed novel early predictive model for placenta previa occurring as the only pregnancy-related disorder.
前置胎盘是指胎盘异常植入子宫下段，与诸如胎盘植入谱系疾病、产前和产后出血、胎儿生长受限、早产、死产和新生儿死亡、血栓性静脉炎及败血症等不良母婴结局相关。本研究的目的是回顾性评估妊娠早期发生的前置胎盘如何影响妊娠早期外周血中的微小RNA表达谱。
鉴于妊娠早期异常微小RNA表达谱与各种妊娠相关并发症的后期发生之间存在关联，我们选择仅发生前置胎盘这一妊娠相关疾病的妊娠进行研究。本研究共纳入24例诊断为前置胎盘且在2012年11月至2018年5月期间接受了孕早期产前筛查并在当地分娩的单胎妊娠。总体而言，基于生物样本储存时间相等，选择80例在妊娠37周后分娩出适于胎龄新生儿的正常妊娠作为对照组。
在注定会发生前置胎盘的妊娠中观察到多种微小RNA（miR-20b-5p、miR-24-3p、miR-26a-5p、miR-92a-3p、miR-103a-3p、miR-130b-3p、miR-133a-3p、miR-145-5p、miR-146a-5p、miR-155-5p、miR-181a-5p、miR-195-5p、miR-210-3p、miR-342-3p和miR-574-3p）表达下调。七种微小RNA（miR-130b-3p、miR-145-5p、miR-155-5p、miR-181a-5p、miR-210-3p、miR-342-3p和miR-574-3p）的组合在妊娠早期区分正常妊娠过程的妊娠和妊娠后半期诊断为前置胎盘的妊娠时显示出最高准确性（曲线下面积0.937，P<0.001，敏感性100.0%，特异性83.75%）。总体而言，在10.0%的假阳性率下，75%注定会发生前置胎盘的妊娠被正确识别。
必须进行连续的大规模分析，以验证所提出的作为唯一妊娠相关疾病发生的前置胎盘新型早期预测模型的可靠性。
