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Mortensen SM, Ekelund CK, Pedersen BW, Tabor A, Rode L. Lack of an association between first-trimester concentration of mid-regional pro-atrial natriuretic peptide and risk of early-onset preeclampsia <34 weeks' gestation. J Obstet Gynaecol Res 2023. [PMID: 37300367 DOI: 10.1111/jog.15700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/15/2023] [Indexed: 06/12/2023]
Abstract
AIM We examined the heart failure biomarker mid-regional pro-atrial natriuretic peptide during the first trimester of pregnancy in relation to early-onset preeclampsia <34 weeks. MATERIALS AND METHODS This case-control study included 34 women with singleton pregnancies with a preeclampsia diagnosis and delivery before 34 weeks of gestation who had attended the routine first-trimester ultrasound scan at 11-13+6 weeks of gestation between August 2010 and October 2015 at the Copenhagen University Hospital Rigshospitalet, Denmark, and 91 uncomplicated singleton pregnancies matched by time of the routine first-trimester blood sampling at 8-13+6 weeks. Descriptive statistical analyses were performed for maternal characteristics and obstetric and medical history for the case versus the control group. Concentrations of mid-regional pro-atrial natriuretic peptide, placental growth factor, soluble fms-like tyrosine kinase-1, and pregnancy-associated plasma protein A between early-onset preeclampsia cases and the control group were compared using Students t-test and the Mann-Whitney U test. Biochemical marker concentrations were converted into multiples of the expected median values after adjustment for gestational age. RESULTS Mid-regional pro-atrial natriuretic peptide levels were not significantly different between early-onset preeclampsia cases and the control group in the first trimester of pregnancy. As expected, both placental growth factor and pregnancy-associated plasma protein A levels were significantly lower in early-onset preeclampsia, whereas soluble fms-like tyrosine kinase-1 levels were not statistically significantly different. CONCLUSION The maternal first-trimester concentration of mid-regional pro-atrial natriuretic peptide, a peptide with multiple biological functions including a relation to cardiovascular disease, was not significantly different in women with early-onset preeclampsia.
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Affiliation(s)
- Signe Milling Mortensen
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Kvist Ekelund
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Berit Woetmann Pedersen
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ann Tabor
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Line Rode
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
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Sun Y, Guo Y, Xu H, Zhao J, Wu D, Hu J, Wang D, Wu L, Peng H, Li H. The relationship between arginine vasopressin gene polymorphisms and plasma copeptin and hypertensive disorders of pregnancy: a nested case-control study. J Hypertens 2023; 41:608-617. [PMID: 36723473 DOI: 10.1097/hjh.0000000000003376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study aims to explore the relationship between polymorphism of the arginine vasopressin (AVP) gene and plasma copeptin concentration with the occurrence of hypertension in pregnancy. METHODS We conducted a matched nested case-control study in Chinese women. The genotypes of rs3729965, rs3761249, rs1410713, rs2740204, and rs2282018 loci of AVP gene and plasma copeptin at 16-20 gestational weeks were detected in 288 patients with gestational hypertension (GH), 82 with preeclampsia (PE), and 14 with chronic hypertension with superimposed preeclampsia (CH-PE) and their healthy matched controls. RESULTS For every natural logarithm unit increment in copeptin, the risks of GH and PE/CH-PE increased by 5.556 (adjusted odds ratio [aOR]: 6.556, 95% confidence interval [CI]: 2.734-15.717) and 3.312 times (aOR: 4.312, 95% CI: 1.168-15.914). Under the dominant model, the genotype CC + CT of rs2282018 and GG + GT of rs3761249 had higher risks of GH than genotype TT, with aORs of 1.757 (95% CI: 1.077-2.867) and 1.814 (95% CI: 1.111-2.963). Allele A of rs3729965 loci had a lower risk of PE/CH-PE than allele G (aOR: 0.441, 95% CI: 0.199-0.978). However, the frequencies of rs1410713 and rs2740204 genotypes were not significantly different between cases and controls. The model of copeptin combined with the AVP gene and traditional factors (TFs) had a higher ability than the TFs model in predicting GH and PE/CH-PE. CONCLUSION Our study confirms that higher plasma copeptin and AVP gene variants are associated with the occurrence of GH and PE/CH-PE. The detection of copeptin and AVP gene in the early second trimester improves the predictive ability of TFs for GH and PE/CH-PE.
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Affiliation(s)
- Yexiu Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou
| | - Ying Guo
- Department of Community Healthcare, Maternal and Child Health Bureau of Kunshan, Kunshan
| | - He Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou
| | - Ji Zhao
- Department of Community Healthcare, Maternal and Child Health Bureau of Kunshan, Kunshan
| | - Di Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou
| | - Jianwei Hu
- Department of Community Healthcare, Maternal and Child Health Bureau of Kunshan, Kunshan
| | - Dandan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou
| | - Lei Wu
- Department of Maternal and Child Health, Suzhou Industrial Park Center for Disease Control and Prevention
| | - Hao Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, PR China
| | - Hongmei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, PR China
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Wang W, Lin R, Yang L, Wang Y, Mao B, Xu X, Yu J. Meta-Analysis of Cardiovascular Risk Factors in Offspring of Preeclampsia Pregnancies. Diagnostics (Basel) 2023; 13:diagnostics13040812. [PMID: 36832300 PMCID: PMC9955836 DOI: 10.3390/diagnostics13040812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/23/2023] Open
Abstract
This study aimed to assess cardiovascular risk factors in the offspring of preeclampsia (PE) pregnancies. PubMed, Web of Science, Ovid, and other foreign language databases, as well as SinoMed, China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Databases, were searched. The case-control studies on cardiovascular risk factors in the offspring of PE pregnancies from 1 January 2010 to 31 December 2019 were collected. A random-effects model or a fixed-effects model was used, and RevMan 5.3 software was used for meta-analysis to determine the OR value and 95%CI of each cardiovascular risk factor. A total of 16 documents were included in this research, all of which were case-control studies, with a total of 4046 cases in the experimental group and 31,505 in the control group. The meta-analysis that was conducted demonstrated that SBP [MD = 1.51, 95%CI (1.15, 1.88)] and DBP [MD = 1.90, 95%CI (1.69, 2.10)] values in the PE pregnancy offspring group presented an elevation relative to the non-PE pregnancy offspring group. The total cholesterol value in the PE pregnancy offspring group presented an elevation relative to the non-PE pregnancy offspring group [MD = 0.11, 95%CI (0.08, 0.13)]. The low-density lipoprotein cholesterol value in the PE pregnancy offspring group was comparable to that in the non-PE pregnancy offspring group [MD = 0.01, 95%CI (-0.02, 0.05)]. The high-density lipoprotein cholesterol value in the PE pregnancy offspring group presented an elevation relative to the non-PE pregnancy offspring group [MD = 0.02, 95%CI (0.01, 0.03)]. The non-HDL cholesterol value in the PE pregnancy offspring group presented an elevation relative to the non-PE pregnancy offspring group [MD = 0.16, 95%CI (0.13, 0.19)]. The triglycerides [MD = -0.02, 95%CI (-0.03, -0.01)] and glucose [MD = -0.08, 95%CI (-0.09, -0.07)] values in the PE pregnancy offspring group presented a depletion relative to the non-PE pregnancy group. The insulin value in the PE pregnancy offspring group presented a depletion relative to the non-PE pregnancy offspring group [MD = -0.21, 95%CI (-0.32, -0.09)]. The BMI value in the PE pregnancy offspring group presented an elevation relative to the non-PE pregnancy offspring group [MD = 0.42, 95%CI (0.27, 0.57)]. In conclusion, dyslipidemia, elevated blood pressure, and increased BMI occur postpartum with PE, all of which are risk factors for cardiovascular diseases.
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Affiliation(s)
- Weikai Wang
- The Second School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
- Department of PICU, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730000, China
| | - Ru Lin
- Endoscopy Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730000, China
| | - Lan Yang
- Department of PICU, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730000, China
| | - Yanxia Wang
- Scientific Research Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730000, China
| | - Baohong Mao
- Scientific Research Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730000, China
| | - Xiaoying Xu
- Perinatal Medical Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730000, China
| | - Jing Yu
- Hypertension Center, The Second Hospital of Lanzhou University, Lanzhou 730000, China
- Correspondence:
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Selective Serotonin Reuptake Inhibitor Use in Pregnancy and Protective Mechanisms in Preeclampsia. Reprod Sci 2023; 30:701-712. [PMID: 35984571 PMCID: PMC9944568 DOI: 10.1007/s43032-022-01065-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/11/2022] [Indexed: 01/25/2023]
Abstract
Depression and preeclampsia share risk factors and are bi-directionally associated with increased risk for each other. Despite epidemiological evidence linking selective serotonin reuptake inhibitors (SSRIs) in pregnancy to preeclampsia, serotonin (5-HT) and vasopressin (AVP) secretion mechanisms suggest that SSRIs may attenuate preeclampsia risk. However, there is a need to clarify the relationship between SSRIs and preeclampsia in humans to determine therapeutic potential. This retrospective cohort study included clinical data from 9558 SSRI-untreated and 9046 SSRI-treated pregnancies. In a subcohort of 233 pregnancies, early pregnancy (< 20 weeks) maternal plasma copeptin, an inert and stable AVP prosegment secreted 1:1 with AVP, was measured by enzyme-linked immunosorbent assay. Diagnoses and depression symptoms (Patient Health Questionnaire-9 [PHQ-9]) were identified via medical records review. Descriptive, univariate, and multivariate regression analyses were conducted (α = 0.05). SSRI use was associated with decreased preeclampsia after controlling for clinical confounders (depression severity, chronic hypertension, diabetes, body mass index, age) (OR = 0.9 [0.7-1.0], p = 0.05). Moderate-to-severe depression symptoms were associated with significantly higher copeptin secretion than mild-to-no depression symptoms (240 ± 29 vs. 142 ± 10 ng/mL, p < 0.001). SSRIs significantly attenuated first trimester plasma copeptin (78 ± 22 users vs. 240 ± 29 ng/ml non-users, p < 0.001). In preeclampsia, SSRI treatment was associated with significantly lower copeptin levels (657 ± 164 vs. 175 ± 134 ng/mL, p = 0.04). Interaction between SSRI treatment and preeclampsia was also significant (p = 0.04). SSRIs may modulate preeclampsia risk and mechanisms, although further studies are needed to investigate the relationships between 5-HT and AVP in depression and preeclampsia.
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Marek A, Stojko R, Drosdzol-Cop A. Copeptin in Patients with Pregnancy-Induced Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126470. [PMID: 34203843 PMCID: PMC8296291 DOI: 10.3390/ijerph18126470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 11/25/2022]
Abstract
Pregnancy-induced hypertension (PIH) occurs in 6–8% of pregnancies, and increases the risk of many severe obstetric complications. The etiology of PIH has not been fully explained, and hence, treatment is only palliative in nature, and prevention is not fully effective. It has been proposed that PIH development is influenced by the arginine vasopressin pathway, whose surrogate biomarker is copeptin. The aim of this study is a prospective assessment of the relationship between the level of copeptin in pregnant women and the occurrence of PIH, and to identify its usefulness in predicting complications. The study involved a group of 21 pregnant women who developed PIH and 37 women with uncomplicated pregnancies as a control group. Blood samples were collected at the three trimesters of gestation (<13 HBD, between 13 and 26 and >26 HBD) and then frozen. Copeptin levels [pg/mL] were measured in serum samples obtained in the first, second and third trimesters of gestation from women in the PIH and control groups. The concentration of copeptin in the second and third trimesters of pregnancy was statistically significantly higher in the PIH group (p < 0.05). For copeptin determined in the first trimester, which could be used to screen for PIH, the area under the ROC curve was 0.650. The highest risk of PIH occurred in patients with high concentrations of copeptin in the first trimester of pregnancy and obesity OR = 5.5 (95% CI 1.0–31.3). The risk of PIH was augmented in patients with high levels of copeptin and an abnormal Doppler result of the uterine arteries OR = 28.4 (95% CI 5.3–152). In conclusion, copeptin levels were found to be elevated in pregnant women before the diagnosis of PIH; however, copeptin should not be used as a stand-alone marker. The combination of copeptin concentration with the other risk factors (diabetes, maternal age and preeclampsia in previous pregnancy) did not improve the diagnostic values of the use of copeptin in the PIH risk assessment, but the combination of copeptin concentration with BMI may be useful in clinical practice. Measurement of copeptin together with a Doppler examination of uterine arteries in the first trimester of pregnancy may be a useful marker in predicting the development of PIH.
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Neuman RI, van der Meer MMA, Saleh L, van den Berg SAA, van den Meiracker AH, Danser AHJ, Visser W. Copeptin and mid-regional pro-atrial natriuretic peptide in women with suspected or confirmed pre-eclampsia: comparison with sFlt-1/PlGF ratio. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:872-878. [PMID: 31975510 DOI: 10.1002/uog.21979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/14/2020] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) may contribute to the pathogenesis of pre-eclampsia (PE), but their role remains to be elucidated. Our aims were to evaluate the surrogates of AVP and ANP, C-terminal pro-AVP (copeptin) and mid-regional pro-ANP (MR-proANP), as biomarkers for the prediction of PE-related pregnancy complications and whether they are associated with angiogenic markers and/or clinical manifestations of PE. METHODS This was a retrospective analysis of a prospective cohort study that enrolled pregnant women with suspected or confirmed PE, between December 2013 and April 2016. From each patient, a blood sample was obtained at study entry and serum levels of copeptin, MR-proANP, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) were measured. We evaluated the ability of sFlt-1, PlGF, sFlt-1/PlGF ratio, copeptin and MR-proANP, assessed either alone or combined with traditional predictors (gestational age, parity, diastolic blood pressure and proteinuria), to predict maternal complications and fetal/neonatal complications. Models were compared using concordance statistic (C-index). RESULTS A total of 526 women were evaluated in the study. Women with confirmed PE displayed elevated serum copeptin and MR-proANP levels in comparison to those with suspected PE but no hypertensive disease of pregnancy. When combined with traditional predictors, the sFlt-1/PlGF ratio displayed a higher C-index than copeptin and MR-proANP (0.76, 0.63 and 0.67, respectively, vs 0.60 for the traditional predictors alone) for the prediction of maternal complications. Similarly, for the prediction of fetal/neonatal complications, the sFlt-1/PlGF ratio displayed a higher C-index than copeptin and MR-proANP when added to the traditional model (0.83, 0.79 and 0.80, respectively, vs 0.79 for the traditional predictors alone). When subdividing women according to sFlt-1/PlGF ratio (≥ 85 vs < 85), no differences in copeptin levels were observed, while MR-proANP level was elevated in women with sFlt-1/PlGF ratio ≥ 85. Multiple regression analysis revealed that copeptin and MR-proANP were independent determinants of proteinuria. CONCLUSIONS Copeptin and MR-proANP have limited value in predicting PE-related complications when compared with the sFlt-1/PlGF ratio. However, both copeptin and MR-proANP were associated with proteinuria, with copeptin exerting this effect independently of the sFlt-1/PlGF ratio. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- R I Neuman
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Obstetrics and Gynecology, Division Obstetrics and Prenatal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - L Saleh
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Obstetrics and Gynecology, Division Obstetrics and Prenatal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - S A A van den Berg
- Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A H van den Meiracker
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A H J Danser
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - W Visser
- Department of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Obstetrics and Gynecology, Division Obstetrics and Prenatal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
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Birdir C, Fox L, Droste L, Frank M, Fryze J, Enekwe A, Köninger A, Kimmig R, Schmidt B, Gellhaus A. MR-proANP, a cardiovascular biomarker to predict late-onset preeclampsia and intrauterine growth restricted fetuses. Pregnancy Hypertens 2020; 22:54-58. [PMID: 32739718 DOI: 10.1016/j.preghy.2020.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/05/2020] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Midregional pro-atrial natriuretic peptide (MR-proANP) is a cardiac biomarker and the maternal serum levels could predict late-onset preeclampsia (PE) or intrauterine growth restriction (IUGR) at third trimester of pregnancy. METHODS We measured MR-proANP between 32 and 37 weeks of pregnancy prospectively: 32 patients suffered from PE and 22 developed IUGR. 676 patients exhibited no pregnancy complications. RESULTS The median MR-proANP showed significantly higher results in PE (64.9 pmol/l (interquartile range (IQR) 36.3-105.2) and IUGR (59.7 pmol/l (IQR 39.7-163.0) groups compared to controls (38.7 pmol/l (IQR 29.7-49.2). Linear regression analysis showed association between PE and MR-proANP levels (Exp(ß) = 1.56; 95% CI: 1.34-1.81). AUC showed a predictive value for PE (AUC: 0.72) and IUGR (AUC: 0.71). CONCLUSIONS Measuring MR-proANP in maternal serum between 32 and 37 weeks of pregnancy could help predicting IUGR and PE diagnosed after 34 week in pregnancy. Thus, we assume that MR-proANP may be an additional biomarker which mirrors the maternal cardiosvascular status next to sFlt-1/PLGF representing the angiogenic status.
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Affiliation(s)
- C Birdir
- Department of Obstetrics and Gynecology, University Hospital of Dresden, Technical University of Dresden, Dresden, Germany.
| | - L Fox
- Department of Gynecology and Obstetrics, University Hospital of Essen, Essen, Germany
| | - L Droste
- Department of Gynecology and Obstetrics, University Hospital of Essen, Essen, Germany
| | - M Frank
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - J Fryze
- Department of Obstetrics and Gynecology, University Hospital of Dresden, Technical University of Dresden, Dresden, Germany
| | - A Enekwe
- Department of Gynecology and Obstetrics, University Hospital of Essen, Essen, Germany
| | - A Köninger
- Department of Gynecology and Obstetrics, University Hospital of Essen, Essen, Germany
| | - R Kimmig
- Department of Gynecology and Obstetrics, University Hospital of Essen, Essen, Germany
| | - B Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - A Gellhaus
- Department of Gynecology and Obstetrics, University Hospital of Essen, Essen, Germany
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Evers KS, Huhn EA, Fouzas S, Barro C, Kuhle J, Fisch U, Bernasconi L, Lapaire O, Wellmann S. Impact of parturition on maternal cardiovascular and neuronal integrity in a high risk cohort - a prospective cohort study. BMC Pregnancy Childbirth 2019; 19:403. [PMID: 31690271 PMCID: PMC6833198 DOI: 10.1186/s12884-019-2570-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 10/23/2019] [Indexed: 12/14/2022] Open
Abstract
Background To better understand the profound multisystem changes in maternal physiology triggered by parturition, in particular in the underexplored neuronal system, by deploying a panel of pre- vs post-delivery maternal serum biomarkers, most notably the neuronal cytoskeleton constituent neurofilament light chain (NfL). This promising fluid biomarker is not only increasingly applied to investigate disease progression in numerous brain diseases, particularly in proteopathies, but also in detection of traumatic brain injury or monitoring neuroaxonal injury after ischemic stroke. Methods The study was nested within a prospective cohort study of pregnant women at risk of developing preeclampsia at the University Hospital of Basel. Paired ante- and postpartum levels of progesterone, soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin (CT-proAVP), and NfL were measured in 56 women with complete clinical data. Results Placental delivery significantly decreased all placental markers: progesterone 4.5-fold, PlGF 2.2-fold, and sFlt-1 1.7-fold. Copeptin and MR-proANP increased slightly (1.4- and 1.2-fold, respectively). Unexpectedly, NfL levels (median [interquartile range]) increased significantly post-partum: 49.4 (34.7–77.8) vs 27.7 (16.7–31.4) pg/ml (p < 0.0001). Antepartum NfL was the sole independent predictor of NfL peri-partum change; mode of delivery, duration of labor, clinical characteristics and other biomarkers were all unrelated. Antepartum NfL levels were themselves independently predicted only by maternal age. Conclusions Parturition per se increases maternal serum NfL levels, suggesting a possible impact of parturition on maternal neuronal integrity.
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Affiliation(s)
- Katrina Suzanne Evers
- Division of Neonatology, University Children's Hospital Basel (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland.
| | - Evelyn Annegret Huhn
- Division of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland
| | - Sotirios Fouzas
- Paediatric Respiratory Unit and Department of Neonatology, University Hospital of Patras, Patras, Greece
| | - Christian Barro
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Urs Fisch
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Luca Bernasconi
- Institute of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Olav Lapaire
- Division of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland
| | - Sven Wellmann
- Division of Neonatology, University Children's Hospital Basel (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland.,Division of Neonatology, University Children's Hospital Regensburg (KUNO), University of Regensburg, Regensburg, Germany
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Jadli A, Ghosh K, Damania K, Satoskar P, Bansal V, Shetty S. Prediction of preeclampsia using combination of biomarkers at 18-23 weeks of gestation: A nested case-control study. Pregnancy Hypertens 2019; 17:20-27. [PMID: 31487641 DOI: 10.1016/j.preghy.2019.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 02/07/2019] [Accepted: 04/21/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSION At 18-23 weeks, Combination of CD62e microparticles, copeptin, and PlGF levels can effectively identify women at risk of developing PE later in gestation.
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Affiliation(s)
- Anshul Jadli
- National Institute of Immunohaematology (ICMR), 13th Floor, KEM Hospital, Parel, Mumbai 400 012, India
| | - Kanjaksha Ghosh
- Surat Raktadan Kendra & Research Centre, Regional Blood Transfusion Centre, Surat 395 002, Gujarat, India
| | - Kaizad Damania
- Nowrosjee Wadia Maternity Hospital, Acharya Donde Marg, Lower Parel, Mumbai 400012, India
| | - Purnima Satoskar
- Nowrosjee Wadia Maternity Hospital, Acharya Donde Marg, Lower Parel, Mumbai 400012, India
| | - Vandana Bansal
- Nowrosjee Wadia Maternity Hospital, Acharya Donde Marg, Lower Parel, Mumbai 400012, India
| | - Shrimati Shetty
- National Institute of Immunohaematology (ICMR), 13th Floor, KEM Hospital, Parel, Mumbai 400 012, India.
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Govender N, Moodley J, Naicker T. Copeptin in Preeclampsia Development. CURRENT WOMEN S HEALTH REVIEWS 2019. [DOI: 10.2174/1573404815666190110094636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background:
Preeclampsia complicates 2-8% of all pregnancies worldwide and is one of
the leading causes of maternal and neonatal morbidity and mortality. It occurs after the 20th week of
gestation and is characterized by high blood pressure, proteinuria or end-organ disease. The heterogeneous
and multi-systemic nature of this disease has led to the elusive pathophysiology which
delays timely diagnoses and the clinical treatment of those affected.
Objective:
Despite the extensive investigations surrounding the inclusion of various potential markers
for PE prediction, early diagnosis remains unresolved. Quantification of copeptin, a stable component
of the arginine vasopressin (AVP) precursor is shown to be relatively reliable in confirming
the circulating levels of AVP.
Conclusion:
Elevated copeptin levels confirmed in pregnant women have also provided clinical
support for its role in PE development. However, its clinical use in predicting disease severity in
early-onset pre-eclampsia has been debatable. This review thus recapitulates the current literature
surrounding copeptin and its potential as a risk indicator for PE development.</P>
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Affiliation(s)
- Nalini Govender
- Department of Basic Medical Sciences, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Jagidesa Moodley
- Women's Health and HIV Research Group, College of Health Sciences, University of Kwa Zulu-Natal, Durban, South Africa
| | - Thajasvarie Naicker
- Discipline of Optics and Imaging, College of Health Sciences, University of Kwa Zulu-Natal, Durban, South Africa
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Buttrup Larsen S, Wallukat G, Schimke I, Sandager A, Tvilum Christensen T, Uldbjerg N, Tørring N. Functional autoantibodies against Endothelin-1 receptor type A and Angiotensin II receptor type 1 in patients with preeclampsia. Pregnancy Hypertens 2018; 14:189-194. [DOI: 10.1016/j.preghy.2018.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/05/2018] [Accepted: 10/12/2018] [Indexed: 12/25/2022]
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Evers KS, Atkinson A, Barro C, Fisch U, Pfister M, Huhn EA, Lapaire O, Kuhle J, Wellmann S. Neurofilament as Neuronal Injury Blood Marker in Preeclampsia. Hypertension 2018; 71:1178-1184. [PMID: 29686016 DOI: 10.1161/hypertensionaha.117.10314] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 10/02/2017] [Accepted: 03/28/2018] [Indexed: 12/13/2022]
Abstract
Preeclampsia has been shown to be associated with changes in cerebral structure and cognitive function later in life. Nf (neurofilaments) are specific scaffolding proteins of neurons, and their quantification in serum has been proposed as a biomarker for neuroaxonal injury. We performed a prospective, longitudinal, single-center study at the University Hospital of Basel to determine serum Nf concentrations in pregnant women with singleton pregnancies and with high risk of preeclampsia or with early signs of preeclampsia. Enrollment started at 21 weeks of gestation, followed up with multiple visits until delivery. Sixty out of 197 women developed preeclampsia (30.5%). NfL (Nf light chain) was measured with a highly sensitive single molecule array (Simoa) assay, in addition to the established preeclampsia markers sFlt-1 (soluble fms-like tyrosine kinase-1) and PlGF (placental growth factor). The most important independent predictors of NfL were maternal age, number of pregnancies, and proteinuria. NfL levels increased during pregnancy and were significantly higher in women developing preeclampsia. The discriminatory accuracy of NfL, PlGF, and sFlt-1 in receiver operating characteristic curves analysis (area under the curve) of the overall group was 0.68, 0.81, and 0.84, respectively, and in women older than 36 years 0.7, 0.62, and 0.79, respectively. We conclude that increased axonal injury serum marker NfL predicts preeclampsia particularly in older women, with an accuracy similar to the established angiogenic factors. NfL may serve as an early indicator of preeclampsia-induced changes in cerebral structure and may help to stratify disease management.
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Affiliation(s)
| | - Andrew Atkinson
- and Division of Paediatric Pharmacology and Pharmacometrics (A.A., M.P.).,University of Basel Children's Hospital (UKBB), Switzerland; Department of Infectious Diseases, University Hospital Bern, Switzerland (A.A.)
| | - Christian Barro
- and Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research (C.B., U.F., J.K.)
| | - Urs Fisch
- and Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research (C.B., U.F., J.K.)
| | - Marc Pfister
- and Division of Paediatric Pharmacology and Pharmacometrics (A.A., M.P.)
| | - Evelyn A Huhn
- and Division of Obstetrics and Gynecology (E.A.H., O.L.) University Hospital Basel, University of Basel, Switzerland
| | - Olav Lapaire
- and Division of Obstetrics and Gynecology (E.A.H., O.L.) University Hospital Basel, University of Basel, Switzerland
| | - Jens Kuhle
- and Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research (C.B., U.F., J.K.)
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Joosen AM, van der Linden IJ, Schrauwen L, Theeuwes A, de Groot MJ, Ermens AA. Reference intervals and longitudinal changes in copeptin and MR-proADM concentrations during pregnancy. ACTA ACUST UNITED AC 2017; 56:113-119. [DOI: 10.1515/cclm-2017-0110] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/25/2017] [Indexed: 12/17/2022]
Abstract
Abstract
Background:
Vasopressin and adrenomedullin and their stable by-products copeptin and midregional part of proadrenomedullin (MR-proADM) are promising biomarkers for the development of preeclampsia. However, clinical use is hampered by the lack of trimester-specific reference intervals. We therefore estimated reference intervals for copeptin and MR-proADM in disease-free Dutch women throughout pregnancy.
Methods:
Apparently healthy low risk pregnant women were recruited. Exclusion criteria included current or past history of endocrine disease, multiple pregnancy, use of medication known to influence thyroid function and current pregnancy as a result of hormonal stimulation. Women who miscarried, developed hyperemesis gravidarum, hypertension, pre-eclampsia, hemolysis elevated liver enzymes and low platelets, diabetes or other disease, delivered prematurely or had a small for gestational age neonate were excluded from analyses. Blood samples were collected at 9–13 weeks (n=98), 27–29 weeks (n=94) and 36–39 weeks (n=91) of gestation and at 4–13 weeks post-partum (PP) (n=89). Sixty-two women had complete data during pregnancy and PP. All analyses were performed on a Kryptor compact plus.
Results:
Copeptin increases during pregnancy, but 97.5th percentiles remain below the non-pregnant upper reference limit (URL) provided by the manufacturer. MR-proADM concentrations increase as well during pregnancy. In trimesters 2 and 3 the 97.5th percentiles are over three times the non-pregnant URL provided by the manufacturer.
Conclusions:
Trimester- and assay-specific reference intervals for copeptin and MR-proADM should be used. In addition, consecutive measurements and the time frame between measurements should be considered as the differences seen with or in advance of preeclampsia can be expected to be relatively small compared to the reference intervals.
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Affiliation(s)
- Annemiek M.C.P. Joosen
- Laboratory of Clinical Chemistry and Haematology , Franciscus Gasthuis and Vlietland , Kleiweg 500 , 3045 PM Rotterdam , The Netherlands
| | | | - Lianne Schrauwen
- Laboratory of Clinical Chemistry and Haematology , Amphia Hospital , Breda , The Netherlands
| | - Alisia Theeuwes
- Laboratory of Clinical Chemistry and Haematology , Elisabeth-TweeSteden Hospital , Tilburg , The Netherlands
| | - Monique J.M. de Groot
- Laboratory of Clinical Chemistry and Haematology , Amphia Hospital , Breda , The Netherlands
- Laboratory of Clinical Chemistry and Haematology , Elisabeth-TweeSteden Hospital , Tilburg , The Netherlands
| | - Antonius A.M. Ermens
- Laboratory of Clinical Chemistry and Haematology , Amphia Hospital , Breda , The Netherlands
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Yeşil A, Kanawati A, Helvacıoğlu Ç, Kaya C, Özgün ÇG, Cengiz H. Identification of patients at risk for preeclampsia with the use of uterine artery Doppler velocimetry and copeptin. J Matern Fetal Neonatal Med 2016; 30:2763-2768. [PMID: 27868455 DOI: 10.1080/14767058.2016.1262841] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To investigate the relationship between maternal copeptin levels and uterine artery Doppler examination and progress of preeclampsia. MATERIALS AND METHODS A cross-sectional study was designed with women those were screened at 20 + 0 - 24+ 6 weeks' gestation between May 2014 and August 2014. The obstetric records of all normotensive women were examined. Uterine artery Doppler velocimetry results and serum copeptin levels were measured. The patients were divided into two groups according to normal (n = 67) and abnormal uterine artery Doppler (n = 21) findings. RESULTS Maternal age was significantly lower in group 1 (n = 21, 23.9%) than in group 2 (n= 67, 76.1%) (p < 0.05). We found no differences in maternal characteristics, birth weight, gestational age at delivery and copeptin levels between the two groups. Maternal serum copeptin levels were higher in women who subsequently developed preeclampsia. There was also a significant correlation between copeptin levels and the presence of preeclampsia. (p = 0.002). CONCLUSIONS Copeptin levels are significantly higher in patients who develop preeclampsia.
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Affiliation(s)
- Ali Yeşil
- a Department of Obstetrics and Gynecology , Erzurum Nenehatun Maternity and Children's Disease Hospital , Erzurum , Turkey
| | - Ammar Kanawati
- b Department of Obstetrics and Gynecology , Bakirkoy Dr Sadi Konuk Training and Research Hospital , Istanbul , Turkey
| | - Çağlar Helvacıoğlu
- b Department of Obstetrics and Gynecology , Bakirkoy Dr Sadi Konuk Training and Research Hospital , Istanbul , Turkey
| | - Cihan Kaya
- b Department of Obstetrics and Gynecology , Bakirkoy Dr Sadi Konuk Training and Research Hospital , Istanbul , Turkey
| | - Çağseli Göksu Özgün
- b Department of Obstetrics and Gynecology , Bakirkoy Dr Sadi Konuk Training and Research Hospital , Istanbul , Turkey
| | - Hüseyin Cengiz
- b Department of Obstetrics and Gynecology , Bakirkoy Dr Sadi Konuk Training and Research Hospital , Istanbul , Turkey
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Álvarez-Fernández I, Prieto B, Rodríguez V, Ruano Y, Escudero AI, Álvarez FV. N-terminal pro B-type natriuretic peptide and angiogenic biomarkers in the prognosis of adverse outcomes in women with suspected preeclampsia. Clin Chim Acta 2016; 463:150-157. [PMID: 27983995 DOI: 10.1016/j.cca.2016.10.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 10/27/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study compares the performance of the soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1/PlGF) ratio and the cardiac biomarker N-terminal pro-B type natriuretic peptide (NT-proBNP) in the prediction of adverse outcomes in women with suspicion of PE. METHODS A retrospective cohort study was conducted on women admitted at triage with signs and/or symptoms of PE (n=340). Serum levels of sFlt-1, PlGF and NT-proBNP were determined by an electrochemiluminescence immunoassay (Roche Diagnostics). The main outcomes were early- or late-onset PE and development of adverse outcome, defined as delivery within the first week since clinical presentation or fetal/early neonatal death. RESULTS NT-proBNP concentrations (ng/L) were significantly increased in PE versus non-PE women, both at <34 (169 versus 34) and ≥34weeks of gestation (101 versus 49) (p<0.001). A cut-point of 70 showed sensitivities/specificities of 78/74% for early-, and 70/62% for late-onset PE; slightly lower than those offered by the sFlt-1/PlGF ratio or uric acid. The respective cut-points of 178 and 219 for sFlt-1/PlGF ratio and NT-proBNP, demonstrated similar performance in the prediction of adverse outcome, with sensitivity/specificity of 95/84% and 94/76%, respectively. CONCLUSION NT-proBNP and sFlt-1/PlGF ratio can be used to predict the development of an adverse outcome.
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Affiliation(s)
- Indira Álvarez-Fernández
- Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Belén Prieto
- Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain; Biochemistry and Molecular Biology Department, University of Oviedo, Spain
| | - Verónica Rodríguez
- Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Yolanda Ruano
- Obstetric and Gynecology Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ana I Escudero
- Obstetric and Gynecology Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Francisco V Álvarez
- Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain; Biochemistry and Molecular Biology Department, University of Oviedo, Spain.
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Blohm ME, Arndt F, Sandig J, Diehl W, Zeller T, Mueller GC, Schlesner C, Mir TS, Blankenberg S, Hecher K, Singer D, Weil J. Cardiovascular biomarkers in paired maternal and umbilical cord blood samples at term and near term delivery. Early Hum Dev 2016; 94:7-12. [PMID: 26851448 DOI: 10.1016/j.earlhumdev.2016.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/18/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Cardiovascular biomarkers might help to identify fetuses or pregnancies at risk. AIM To examine the umbilical cord neonatal and maternal levels of cardiovascular biomarkers at the time of delivery, and to correlate maternal and fetal biomarker levels to each other, to gestational age and to delivery mode. STUDY DESIGN In a prospective, observational, cross-sectional, single-center study biomarkers were measured in paired maternal and umbilical venous cord blood samples. SUBJECTS The sample cohort included 66 sets of fetal and maternal blood samples (11 after multiple gestation, 53 after cesarean section, 17 after exposure to labor). OUTCOME MEASURES Midregional pro-adrenomedullin (MRproADM), midregional-pro atrial natriuretic peptide (MRproANP), brain natriuretic peptide (BNP), n-terminal-pro brain natriuretic peptide (NTproBNP), copeptin, and high sensitive troponin I (hsTnI) levels were measured. RESULTS Mean ± SEM for biomarker levels in umbilical venous/maternal blood were: MRproADM [nmol/L] 1.02 ± 0.04/1.24 ± 0.08, MRproANP [pmol/L] 215.53 ± 12.96/54.65 ± 3.41, BNP [pg/mL] 32.02 ± 3.37/19.76 ± 3.29, NTproBNP [pg/mL] 1228.94 ± 91.73/71.48 ± 8.65, copeptin [pmol/L] 103.42 ± 22.89/10.41 ± 1.71, and hsTnI [pg/mL] 13.54 ± 5.17/4.91 ± 2.37. Fetal MRproANP, NTproBNP, and BNP were inversely correlated with gestational age. Maternal and fetal MRproANP (r=0.472, p=0.002) and copeptin (r=0.572, p<0.001) levels were correlated, whereas there was no feto-maternal correlation for the other biomarkers. Fetal copeptin was elevated after exposure to labor. CONCLUSIONS Biomarker levels appear to be regulated independently in mother and fetus. Fetal biomarkers are influenced by gestational age and delivery mode. In this study on term and near term pregnancies without specific fetal pathology, correlation between paired maternal and fetal biomarker levels was weak or not demonstrable.
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Affiliation(s)
- Martin E Blohm
- University Children's Hospital, Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany.
| | - Florian Arndt
- University Heart Center, Clinic for Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Sandig
- University Children's Hospital, Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - Werner Diehl
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tanja Zeller
- University Heart Center, Clinic for General and Interventional Cardiology, German Center for Cardiovascular Research (DZHK), Partner Sites Hamburg, Lübeck, Kiel, Hamburg, Germany
| | - Goetz C Mueller
- University Heart Center, Clinic for Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Schlesner
- University Heart Center, Clinic for Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas S Mir
- University Heart Center, Clinic for Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Blankenberg
- University Heart Center, Clinic for General and Interventional Cardiology, German Center for Cardiovascular Research (DZHK), Partner Sites Hamburg, Lübeck, Kiel, Hamburg, Germany
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominique Singer
- University Children's Hospital, Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - Jochen Weil
- University Heart Center, Clinic for Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Akinlade KS, Adediji IO, Rahamon SK, Fawole AO, Tongo OO. Serum copeptin and pregnancy outcome in preeclampsia. Niger Med J 2016; 56:362-8. [PMID: 26778890 PMCID: PMC4698854 DOI: 10.4103/0300-1652.170385] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background: A number of biochemical predictors of preeclampsia have been reported, but little is known about their possible relationship with maternal and fetal outcomes. This study determined serum copeptin in pregnant women with preeclampsia and assessed its relationship with pregnancy outcomes. Materials and Methods: Thirty women with severe preeclampsia (SP), 30 with mild preeclampsia (MP), and 30 with uncomplicated pregnancy were enrolled into this study. Serum copeptin, creatinine, and liver function were determined using enzyme-linked immunosorbent assay and colorimetry as appropriate. Pregnancy outcomes, both maternal and fetal, were taken using standard methods. Results: Copeptin was significantly elevated in preeclampsia subjects compared with controls and in SP compared with MP. Assessing the diagnostic property of copeptin for preeclampsia, the area under the curve for copeptin was 0.99. Nine (30%) and 3 (10%) of SP and MP, respectively had abruptio placenta while 6 (20%), 2 (6.7%), and 1 (3.3%) still births were recorded in SP, MP, and controls, respectively. Neonates of mothers with preeclampsia had significantly lower birth weight, infant length, ponderal index, and head circumference compared with neonates of the controls. Copeptin had a significant inverse relationship with birth weight, ponderal index, head circumference, Apgar score, and infant length in neonates of mothers with preeclampsia. Conclusion: Serum copeptin level in the third trimester could predict preeclampsia and its elevation is associated with adverse perinatal outcome.
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Affiliation(s)
- Kehinde Sola Akinlade
- Department of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Isaac Oluwole Adediji
- Department of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Sheu Kadiri Rahamon
- Department of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Adeniran Olubukola Fawole
- Department of Obstetrics and Gynaecology, University of Ibadan/University College Hospital, Ibadan, Nigeria
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Łukaszyk E, Małyszko J. Copeptin: Pathophysiology and potential clinical impact. Adv Med Sci 2015; 60:335-41. [PMID: 26233637 DOI: 10.1016/j.advms.2015.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/29/2015] [Accepted: 07/02/2015] [Indexed: 12/24/2022]
Abstract
Copeptin, a C-terminal part of the precursor pre-provasopressin is a novel biomarker of arginine-vasopressin (AVP) system. Measurements of AVP concentration are not used in clinical practice because of technical difficulties. Copeptin is synthesized in stoichiometric ratio with AVP, hence it reflects vasopressin concentration in human plasma and serum. This review outlines current research concerning the role of copeptin as a prognostic marker in different diseases and its potential clinical value.
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Promising prognostic markers of Preeclampsia: New avenues in waiting. Thromb Res 2015; 136:189-95. [DOI: 10.1016/j.thromres.2015.05.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 05/12/2015] [Accepted: 05/12/2015] [Indexed: 12/28/2022]
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Yeung EH, Liu A, Mills JL, Zhang C, Männistö T, Lu Z, Tsai MY, Mendola P. Increased levels of copeptin before clinical diagnosis of preeclampsia. Hypertension 2014; 64:1362-7. [PMID: 25225209 DOI: 10.1161/hypertensionaha.114.03762] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Copeptin, a surrogate biomarker of vasopressin, has been associated with renal function decline and may serve as a useful early biomarker for preeclampsia. We measured serum copeptin using samples collected longitudinally during pregnancy among unaffected controls (n=136) and cases of preeclampsia (n=169), gestational diabetes mellitus (n=92), gestational hypertension (n=101), and preterm birth (n=86) in the Calcium for Preeclampsia Prevention trial (1992-1995). Preeclampsia and gestational hypertension were defined as having a diastolic blood pressure≥90 mm Hg on 2 occasions with and without proteinuria, respectively. The risk of pregnancy complications associated with copeptin was estimated by logistic regression adjusting for maternal age, race, body mass index, insurance status, marital status, current smoking, and clinical site. Baseline copeptin levels, at mean 16 weeks of gestation, were associated with increased preeclampsia risk (adjusted odds ratios and 95% confidence interval being 1.55 per log unit; 1.03-2.31) when compared with controls (P=0.03). The association was stronger among cases diagnosed before 37 weeks (1.86; 1.08-3.20) than those diagnosed later (1.45; 0.91-2.32). Copeptin levels rose with increasing gestational age in both cases and controls but remained significantly higher among those who were diagnosed with preeclampsia. Differences in levels of copeptin between cases and controls became more apparent closer to time of diagnosis. No significant associations were found for gestational hypertension without proteinuria, gestational diabetes mellitus, or preterm birth without preeclampsia. Copeptin levels are elevated in pregnant women before diagnosis of preeclampsia with elevation specific to this pregnancy complication rather than hypertension alone.
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Affiliation(s)
- Edwina H Yeung
- From the Epidemiology Branch (E.H.Y., J.L.M., C.Z., T.M., P.M.) and Biostatistics and Bioinformatics Branch (A.L.) in the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Glotech, Inc, Rockville, MD (Z.L.); and Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.Y.T.).
| | - Aiyi Liu
- From the Epidemiology Branch (E.H.Y., J.L.M., C.Z., T.M., P.M.) and Biostatistics and Bioinformatics Branch (A.L.) in the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Glotech, Inc, Rockville, MD (Z.L.); and Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.Y.T.)
| | - James L Mills
- From the Epidemiology Branch (E.H.Y., J.L.M., C.Z., T.M., P.M.) and Biostatistics and Bioinformatics Branch (A.L.) in the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Glotech, Inc, Rockville, MD (Z.L.); and Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.Y.T.)
| | - Cuilin Zhang
- From the Epidemiology Branch (E.H.Y., J.L.M., C.Z., T.M., P.M.) and Biostatistics and Bioinformatics Branch (A.L.) in the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Glotech, Inc, Rockville, MD (Z.L.); and Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.Y.T.)
| | - Tuija Männistö
- From the Epidemiology Branch (E.H.Y., J.L.M., C.Z., T.M., P.M.) and Biostatistics and Bioinformatics Branch (A.L.) in the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Glotech, Inc, Rockville, MD (Z.L.); and Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.Y.T.)
| | - Zhaohui Lu
- From the Epidemiology Branch (E.H.Y., J.L.M., C.Z., T.M., P.M.) and Biostatistics and Bioinformatics Branch (A.L.) in the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Glotech, Inc, Rockville, MD (Z.L.); and Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.Y.T.)
| | - Michael Y Tsai
- From the Epidemiology Branch (E.H.Y., J.L.M., C.Z., T.M., P.M.) and Biostatistics and Bioinformatics Branch (A.L.) in the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Glotech, Inc, Rockville, MD (Z.L.); and Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.Y.T.)
| | - Pauline Mendola
- From the Epidemiology Branch (E.H.Y., J.L.M., C.Z., T.M., P.M.) and Biostatistics and Bioinformatics Branch (A.L.) in the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Glotech, Inc, Rockville, MD (Z.L.); and Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.Y.T.)
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Affiliation(s)
- Denise C Cornelius
- From the Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson.
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Matson BC, Corty RW, Karpinich NO, Murtha AP, Valdar W, Grotegut CA, Caron KM. Midregional pro-adrenomedullin plasma concentrations are blunted in severe preeclampsia. Placenta 2014; 35:780-3. [PMID: 25043691 DOI: 10.1016/j.placenta.2014.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 06/27/2014] [Accepted: 07/02/2014] [Indexed: 11/19/2022]
Abstract
Levels of the peptide hormone adrenomedullin (AM) are elevated during normal pregnancy, but whether this differs during complications of pregnancy remains unresolved. AM can be quantified by measuring its pre-prohormone byproduct, midregional pro-adrenomedullin (MR-proADM). MR-proADM has shown prognostic value as a biomarker of heart failure, sepsis, and community-acquired pneumonia. Given the relevance of AM to pregnancy, we tested the hypothesis that MR-proADM provides a biomarker for preeclampsia. We find that MR-proADM plasma concentrations are blunted in severe preeclampsia and that MR-proADM is similarly effective as established biomarkers endoglin and placental growth factor at discriminating patients with severe preeclampsia from controls.
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Affiliation(s)
- B C Matson
- Departments of Cell Biology & Physiology, University of North Carolina at Chapel Hill, NC 27599, USA.
| | - R W Corty
- Departments of Genetics, University of North Carolina at Chapel Hill, NC 27599, USA.
| | - N O Karpinich
- Departments of Cell Biology & Physiology, University of North Carolina at Chapel Hill, NC 27599, USA.
| | - A P Murtha
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Duke University School of Medicine, Durham, NC 27710, USA.
| | - W Valdar
- Departments of Genetics, University of North Carolina at Chapel Hill, NC 27599, USA.
| | - C A Grotegut
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Duke University School of Medicine, Durham, NC 27710, USA.
| | - K M Caron
- Departments of Cell Biology & Physiology, University of North Carolina at Chapel Hill, NC 27599, USA; Departments of Genetics, University of North Carolina at Chapel Hill, NC 27599, USA.
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