American Journal of Obstetrics & Gynecology
Volume 199, Issue 2 , Pages 122.e1-122.e11, August 2008

First-trimester maternal serum PP13 in the risk assessment for preeclampsia

Presented at the 27th Annual Meeting of the Society for Maternal-Fetal Medicine, San Francisco, CA, Feb. 5-10, 2007.

  • Roberto Romero, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI
    • Corresponding Author InformationReprints: Roberto Romero, MD, Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Wayne State University/Hutzel Women's Hospital, 3990 John R, Box 4, Detroit, MI 48201.
    • ,
  • Juan Pedro Kusanovic, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Nandor Gabor Than, MD, PhD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • First Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
    • ,
  • Offer Erez, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • ,
  • Francesca Gotsch, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • ,
  • Jimmy Espinoza, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Samuel Edwin, PhD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • ,
  • Ilana Chefetz, MSc

      Affiliations

    • Diagnostic Technologies, Yokneam, Israel
    • ,
  • Ricardo Gomez, MD

      Affiliations

    • Center for Perinatal Diagnosis and Research, Sótero del Río Hospital, P. Universidad Católica de Chile, Puente Alto, Chile
    • ,
  • Jyh Kae Nien, MD

      Affiliations

    • Center for Perinatal Diagnosis and Research, Sótero del Río Hospital, P. Universidad Católica de Chile, Puente Alto, Chile
    • ,
  • Marei Sammar, PhD

      Affiliations

    • Diagnostic Technologies, Yokneam, Israel
    • ,
  • Beth Pineles, BS

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • ,
  • Sonia S. Hassan, MD

      Affiliations

    • Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Hamutal Meiri, PhD

      Affiliations

    • Diagnostic Technologies, Yokneam, Israel
    • ,
  • Yossi Tal, PhD

      Affiliations

    • TechnoSTAT, Kfar Sabah, Israel
    • ,
  • Ido Kuhnreich, MSc

      Affiliations

    • TechnoSTAT, Kfar Sabah, Israel
    • ,
  • Zoltan Papp, MD, DSci

      Affiliations

    • First Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
    • ,
  • Howard S. Cuckle, PhD

      Affiliations

    • Leeds Screening Centre, University of Leeds, Leeds, UK
    • Department of Obstetrics and Gynecology, Columbia University, New York, NY.

Received 9 July 2007; received in revised form 17 October 2007; accepted 11 January 2008. published online 09 June 2008.

Objective

The objective of the study was to determine whether first-trimester maternal serum placental protein 13 (PP13) concentrations can be used in the risk assessment for preeclampsia.

Study Design

This case-control study included 50 patients with preeclampsia and 250 patients with normal pregnancies. Samples were collected between 8 and 13 weeks of gestation. Serum PP13 concentrations were measured by immunoassay and expressed as medians and multiples of the median (MoM) for gestational age. Sensitivity and specificity were derived from receiver-operating characteristic curve analysis.

Results

(1) Serum PP13 concentration in the first trimester was significantly lower in patients who developed preterm and early-onset preeclampsia than in those with normal pregnancies; and (2) at 80% specificity, a cutoff of 0.39 MoM had a sensitivity of 100% for early-onset preeclampsia and 85% for preterm preeclampsia.

Conclusion

Maternal serum first-trimester PP13 appears to be a reasonable marker for risk assessment for preterm preeclampsia but a weak marker for severe preeclampsia at term, and ineffective for identifying mild preeclampsia at term.

Key words: high-risk pregnancy, maternal serum biochemistry, prenatal care, risk assessment, screening

 

 Cite this article as: Romero R, Kusanovic JP, Than NG, et al. First-trimester maternal serum PP13 in the risk assessment for preeclampsia. Am J Obstet Gynecol 2008;199:122.e1-122.e11.

 This research was supported, in part, by the Intramural Research Program of the National Institute of Child Health and Human Development, Eunice Kennedy Shriver National Institutes of Health, Department of Health and Human Services, and Grants 31851 and 42872 from Israel Chief Scientist (to H.M.).

PII: S0002-9378(08)00028-8

doi:10.1016/j.ajog.2008.01.013

American Journal of Obstetrics & Gynecology
Volume 199, Issue 2 , Pages 122.e1-122.e11, August 2008

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