Zeng Shuai, Qu Jiangxue, Jiang Hai, Shi Huifeng, Yan Jie, Zhao Yangyu, Chen Lian
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2025 Jul 24;16:1627377. doi: 10.3389/fendo.2025.1627377. eCollection 2025.
Placenta accreta spectrum (PAS) disorders are a series of gestational diseases, with severe adverse outcomes. Apolipoprotein A1 (APOA1) is a lipid molecule that plays a role in cell invasion, inflammation and immune response. This study aimed to elucidate the relationship between APOA1 and PAS, as well as its adverse outcomes.
This is a nested case-control study involving 118 patients with PAS and 118 non-PAS control women. Plasma APOA1 levels were evaluated at gestational weeks 24 to 35 by enzyme-linked immunosorbent assay. The clinical characteristics and pregnancy outcomes were recorded and analyzed in relation to APOA1 levels.
The plasma APOA1 level in the PAS group was observed to be lower than that in the non-PAS group ( = 0.035). From 24 to 35 weeks of gestation, the trajectory of plasma APOA1 levels in the placenta percreta (PP) and placenta increta group exhibited a discernible decline. Maternal plasma APOA1 is a significant biomarker for the diagnosis of PAS and its adverse outcomes, particularly in the 32 to 35 weeks of gestation range for invasive PAS (AUC = 0.761, 95% CI 0.660-0.863, < 0.001), PP (AUC = 0.889, 95% CI 0.801-0.976, < 0.001), blood transfusion (AUC = 0.729, 95% CI 0.620-0.838, < 0.001) and hysterectomy (AUC = 0.884, 95% CI 0.790-0.978, < 0.001).
A reduction in maternal plasma APOA1 levels was associated with the severity of PAS. APOA1 may serve as a biomarker for invasive PAS, blood transfusion and hysterectomy in late gestation.
胎盘植入谱系（PAS）疾病是一系列妊娠疾病，会导致严重不良后果。载脂蛋白A1（APOA1）是一种脂质分子，在细胞侵袭、炎症和免疫反应中发挥作用。本研究旨在阐明APOA1与PAS及其不良后果之间的关系。
这是一项巢式病例对照研究，纳入了118例PAS患者和118例非PAS对照女性。在妊娠24至35周时，采用酶联免疫吸附测定法评估血浆APOA1水平。记录并分析与APOA1水平相关的临床特征和妊娠结局。
观察到PAS组的血浆APOA1水平低于非PAS组（=0.035）。在妊娠24至35周期间，穿透性胎盘植入（PP）和侵入性胎盘植入组的血浆APOA1水平轨迹呈现出明显下降。母体血浆APOA1是诊断PAS及其不良后果的重要生物标志物，特别是在妊娠32至35周范围内用于诊断侵入性PAS（AUC=0.761，95%CI 0.660-0.863，<0.001）、PP（AUC=0.889，95%CI 0.801-0.976，<0.001）、输血（AUC=0.729，95%CI 0.620-0.838，<0.001）和子宫切除术（AUC=0.884，95%CI 0.790-0.978，<0.001）。
母体血浆APOA1水平降低与PAS的严重程度相关。APOA1可能作为妊娠晚期侵入性PAS、输血和子宫切除术的生物标志物。
