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Morgan JC, Ernst LM, Grable I. Elevation of Maternal Serum α-Fetoprotein: Implications for the Neonate. Neoreviews 2024; 25:e117-e121. [PMID: 38296791 DOI: 10.1542/neo.25-2-e117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Affiliation(s)
- Jessica Celine Morgan
- Department of Obstetrics and Gynecology, University of Chicago/NorthShore University Health System, Evanston, IL
| | - Linda M Ernst
- Department of Pathology and Laboratory Medicine, NorthShore University Health System, Evanston, IL
| | - Ian Grable
- Department of Obstetrics and Gynecology, University of Chicago/NorthShore University Health System, Evanston, IL
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Pradhan A, Mishra P, Tiwari S, Choure K, Gupta A. Prediction of Low Birth Weight by Quadruple Parameters in High-Risk Pregnancies. Int J Appl Basic Med Res 2022; 12:277-283. [PMID: 36726653 PMCID: PMC9886151 DOI: 10.4103/ijabmr.ijabmr_155_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/16/2022] [Accepted: 11/03/2022] [Indexed: 12/24/2022] Open
Abstract
Context Aneuploidy screening is done in the early second trimester of pregnancy among all pregnant women as compulsory, with a special focus on those who had abnormal ultrasound parameters, higher dual marker risk, or other comorbidities. Recently, all individual quad markers of conventional trisomy screening have been suggested as useful in predicting adverse pregnancy outcomes (APO) such as preeclampsia, preterm labor, small for gestational age, and placental abruptions. However, similar studies on Indian pregnant women are limited. Hence, this study was intended to find the relation of quadruple markers with any other APO than aneuploidy. Materials and Methods A retrospective study was conducted in a Tertiary Care multi-specialty hospital in North India. Data from 252 pregnant women's quadruple test was analyzed. The association of abnormal value of quadruple markers (human chorionic gonadotropin [HCG]/alpha-fetoprotein/uE3/Inhibin A) with adverse outcomes was evaluated. Multiple logistic regression analysis and classification and regression tree were used to predict the significant risk factor in high-risk pregnancies. Results In the study, a total (n = 252) of pregnant women, 190 were screened as high-risk pregnancies, whereas the remaining 62 were reported as low-risk using trisomy screening in the quadruple test. Baby birth weight was observed to be significantly associated with Inhibin-A, and HCG (P < 0.001), whereas Corrected (Corr)-multiple of median (MoM)-HCG (>1.415) and Inhibin-A Corr-MoM (>364.175) were the suitable predictor for the LBW. Both parameters were significantly higher in the high-risk group as compared to the low-risk group (each P < 0.05). Conclusion Abnormal deviation of biochemical markers from aneuploidy screening assessment could help predict other perinatal adverse outcomes such as low birth weight babies.
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Affiliation(s)
- Avani Pradhan
- Department of Molecular Medicine and Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
- Department of Biotechnology, AKS University, Satna, Madhya Pradesh, India
| | - Prabhakar Mishra
- Department of Biostatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Swasti Tiwari
- Department of Molecular Medicine and Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kamlesh Choure
- Department of Biotechnology, AKS University, Satna, Madhya Pradesh, India
| | - Amrit Gupta
- Department of Maternal Health and Reproduction, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Alizadeh-Dibazari Z, Alizadeh-Ghodsi Z, Fathnezhad-kazemi A. Association Between Serum Markers Used in the Routine Prenatal Screening with Pregnancy Outcomes: A Cohort Study. J Obstet Gynaecol India 2022; 72:6-18. [PMID: 35928095 PMCID: PMC9343500 DOI: 10.1007/s13224-021-01508-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 05/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background Early detection of adverse pregnancy outcomes is an important topic in prenatal care. This study aimed to evaluate the association between maternal serum markers and pregnancy outcomes. Materials and Methods This hospital-based cohort study was performed according to the national Down syndrome screening protocol on 2923 eligible pregnant women. Pregnancies were classified into three groups of based on each biomarker. The participants were followed up until delivery, and the pregnancy outcomes were identified by hospital discharge records. Results High levels of free BHCG were significantly associated with an increased risk of preterm birth (B = - 0.31, SE = 0.158, OR = 0.730; P = 0.046). Based on multivariate analysis the high levels of MSAFP had a direct relationship with premature birth (B = - 0.84, SE = 0.361, OR = 0.431, P = 0.020), gestational hypertension (B = - 0.59, SE = 0.354, OR = 0.549. P = 0.091), IUGR (B = - 1.46, SE = 0.433, OR = 0.231, P = 0.001), and fetal death (B = - 1.50, SE = 0.533, OR = 0.223, P = 0.005). Furthermore, an increase in the levels of Inhibin-A could more likely lead to gestational hypertension (B = - 0.63, SE = 0.235, OR = 0.533). Discussion According to the result, maternal biomarkers, especially MSAFP, can be beneficial in identifying high-risk cases, in addition to examining the possibility of Down syndrome, facilitating achievement of the desired pregnancy outcomes.
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Wang Y, Ma L, Jia S, Liu D, Gu H, Wei X, Ma W, Luo W, Bai Y, Wang W, Yuan Z. Serum exosomal coronin 1A and dynamin 2 as neural tube defect biomarkers. J Mol Med (Berl) 2022; 100:1307-1319. [PMID: 35915349 PMCID: PMC9402777 DOI: 10.1007/s00109-022-02236-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/18/2022] [Accepted: 07/07/2022] [Indexed: 11/30/2022]
Abstract
Abstract No highly specific and sensitive biomarkers have been identified for early diagnosis of neural tube defects (NTDs). In this study, we used proteomics to identify novel proteins specific for NTDs. Our findings revealed three proteins showing differential expression during fetal development. In a rat model of NTDs, we used western blotting to quantify proteins in maternal serum exosomes on gestational days E18, E16, E14, and E12, in serum on E18 and E12, in neural tubes on E18 and E12, and in fetal neural exosomes on E18. The expression of coronin 1A and dynamin 2 was exosome-specific and associated with spina bifida aperta embryogenesis. Furthermore, coronin 1A and dynamin 2 were significantly downregulated in maternal serum exosomes (E12–E18), neural tubes, and fetal neural exosomes. Although downregulation was also observed in serum, the difference was not significant. Differentially expressed proteins were further analyzed in the serum exosomes of pregnant women during gestational weeks 12–40 using enzyme-linked immunosorbent assays. The findings revealed that coronin 1A and dynamin 2 showed potential diagnostic efficacy during gestational weeks 12–40, particularly during early gestation (12–18 weeks). Therefore, these two targets are used as candidate NTD screening and diagnostic biomarkers during early gestation. Key messages We used proteomics to identify novel proteins specific for NTDs. CORO1A and DNM2 showed exosome-specific expression and were associated with SBA. CORO1A and DNM2 were downregulated in maternal serum exosomes and FNEs. CORO1A and DNM2 showed good diagnostic efficacy for NTDs during early gestation. These two targets may have applications as NTD screening and diagnostic biomarkers.
Supplementary information The online version contains supplementary material available at 10.1007/s00109-022-02236-w.
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Affiliation(s)
- Yanfu Wang
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China.,Department of Pediatric Surgery, Neonatal Surgery, Shengjing Hospital, China Medical University, Shenyang, People's Republic of China
| | - Ling Ma
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China.,Department of Pathophysiology, College of Basic Medical Science, China Medical University, Shenyang, People's Republic of China
| | - Shanshan Jia
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China
| | - Dan Liu
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China
| | - Hui Gu
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China
| | - Xiaowei Wei
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China
| | - Wei Ma
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China
| | - Wenting Luo
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China
| | - Yuzuo Bai
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China
| | - Weilin Wang
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China
| | - Zhengwei Yuan
- Department of Pediatric Surgery, Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, People's Republic of China.
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Neri I, Menichini D, Monari F, Bascio LS, Banchelli F, Facchinetti F. Perinatal outcomes in women affected by different types of headache disorders: A prospective cohort study. Cephalalgia 2021; 41:1492-1498. [PMID: 34282633 DOI: 10.1177/03331024211029236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aims to investigate pregnancy and perinatal outcomes in women with tension-type headache, migraine without aura and migraine with aura by comparing them to women without any headache disorders. STUDY DESIGN Prospective cohort study including singleton pregnancies attending the first trimester aneuploidy screening at the University Hospital of Modena, in Northern Italy, between June 2018 and December 2019. RESULTS A total of 515 consecutive women were included and headache disorders were reported in 43.5% of them (224/515). Tension-type headache was diagnosed in 24.3% of the cases, while 14% suffered from migraine without aura and 5.2% from migraine with aura. Birthweight was significantly lower in women affected by migraine with aura respective to other groups, and a significantly higher rate of small for gestational age infants was found in tension-type headache (10.4%) and in migraine with aura (24.9%) groups respective to the others (p < 0.001). Moreover, the admission to the neonatal intensive care unit was significantly higher in all the headache groups (p = 0.012). Multivariate analysis showed that women presenting tension-type headache (OR 4.19, p = 0.004), migraine with aura (OR 5.37, p = 0.02), a uterine artery pulsatility index >90th centile (OR 3.66, p = 0.01), low multiple of the median (MoM) of Pregnancy-associated plasma protein-A (PAPP-A) (OR 0.48, p = 0.05) and high MoM of Inhibin-A (OR 3.24, p = 0.03) at first trimester, are independently associated with the delivery of small for gestational age infants when compared to women without headache disorders. CONCLUSION Migraine with aura and tension type headache expose women to an increased risk of delivering small for gestational age infants, in association with some utero-placenta markers evaluated at first trimester. These women with headache disorders have an additional indication to undergo first trimester aneuploidy screening and would possibly benefit from specific interventions.
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Affiliation(s)
- Isabella Neri
- Gynecology & Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy
| | - Daniela Menichini
- International Doctorate School in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Monari
- Gynecology & Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy
| | - Ludovica Spanò Bascio
- Gynecology & Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy
| | - Federico Banchelli
- Department of Diagnostic, Clinical and Public Health Medicine, Statistics Unit, 9306University of Modena and Reggio Emilia, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Facchinetti
- Gynecology & Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy
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Dong N, Gu H, Liu D, Wei X, Ma W, Ma L, Liu Y, Wang Y, Jia S, Huang J, Wang C, He X, Huang T, He Y, Zhang Q, An D, Bai Y, Yuan Z. Complement factors and alpha-fetoprotein as biomarkers for noninvasive prenatal diagnosis of neural tube defects. Ann N Y Acad Sci 2020; 1478:75-91. [PMID: 32761624 DOI: 10.1111/nyas.14443] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/30/2020] [Accepted: 06/29/2020] [Indexed: 12/23/2022]
Abstract
Neural tube defects (NTDs) are serious congenital malformations. In this study, we aimed to identify more specific and sensitive maternal serum biomarkers for noninvasive NTD screenings. We collected serum from 37 pregnant women carrying fetuses with NTDs and 38 pregnant women carrying normal fetuses. Isobaric tags for relative and absolute quantitation were conducted for differential proteomic analysis, and an enzyme-linked immunosorbent assay was used to validate the results. We then used a support vector machine (SVM) classifier to establish a disease prediction model for NTD diagnosis. We identified 113 differentially expressed proteins; of these, 23 were either up- or downregulated 1.5-fold or more, including five complement proteins (C1QA, C1S, C1R, C9, and C3); C3 and C9 were downregulated significantly in NTD groups. The accuracy rate of the SVM model of the complement factors (including C1QA, C1S, and C3) was 62.5%, with 60% sensitivity and 67% specificity, while the accuracy rate of the SVM model of alpha-fetoprotein (AFP, an established biomarker for NTDs) was 62.5%, with 75% sensitivity and 50% specificity. Combination of the complement factor and AFP data resulted in the SVM model accuracy of 75%, and receiver operating characteristic curve analysis showed 75% sensitivity and 75% specificity. These data suggest that a disease prediction model based on combined complement factor and AFP data could serve as a more accurate method of noninvasive prenatal NTD diagnosis.
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Affiliation(s)
- Naixuan Dong
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China.,School of Sino-Dutch Biomedical & Information Engineering, Northeastern University, Shenyang, China
| | - Hui Gu
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Dan Liu
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Xiaowei Wei
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Wei Ma
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Ling Ma
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Yusi Liu
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Yanfu Wang
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Shanshan Jia
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Jieting Huang
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Chenfei Wang
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Xuan He
- School of Sino-Dutch Biomedical & Information Engineering, Northeastern University, Shenyang, China
| | - Tianchu Huang
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Yiwen He
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
| | - Qiang Zhang
- Second Respiratory Department, Shengjing Hospital, China Medical University, Shenyang, China
| | - Dong An
- Pediatric Department, The First Hospital of China Medical University, Shenyang, China
| | - Yuzuo Bai
- Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Zhengwei Yuan
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, China
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Agarwal R, Kumari R, Mehndiratta M, Radhakrishnan G, Faridi MMA, Chandra N. Pregnancy-Associated Plasma Protein A Levels in Late First Trimester Pregnancies with Small-for-Gestational Age Neonates: A Prospective Case-Control Study. J Obstet Gynaecol India 2017; 67:247-252. [PMID: 28706362 PMCID: PMC5491410 DOI: 10.1007/s13224-016-0954-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 11/11/2016] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE We aimed to investigate the association of pregnancy associated plasma protein A (PAPP-A) levels in late first trimester with small for gestational age (SGA) neonates and adverse pregnancy outcomes in a low-income setting. METHODS The inclusion criteria were late first trimester (11-13 + 6 weeks) women with singleton and non-anomalous pregnancy. Enrolled participants were sampled for PAPP-A and prospectively followed up for delivery outcome and antenatal complications. A multiple of median (MoM) was calculated and statistically compared between groups. RESULTS Out of total 284 subjects, 14.54% delivered SGA babies and formed cases (Group A), 66.5% delivered appropriate for gestational age (AGA) neonates with uneventful antenatal period (controls, Group B), and 19.3% were AGA group with adverse pregnancy complications (Group C). The late first trimester median PAPP-A MoM was significantly lower (0.61) in Group A compared to Group B (1.47). Using receiver operating characteristic (ROC) curve for PAPP-A MoM, optimal cutoff value was found at 0.45 MoM, with positive predictive value of 56.2%, specificity of 92.6% and sensitivity of 45%. The median interquartile range (IQR) of PAPP-A MoM value in Group C in comparison with Group B was significantly lower except for abruption. At PAPP-A MoM cutoff value <1, <0.8, <0.6 and <0.4, the odds ratio for adverse pregnancy outcome was 8.30, 7.29, 10.97 and 10.60, respectively, indicating an inverse relationship. CONCLUSION With 0.45 MoM cutoff of PAPP-A, the detection rate, specificity and positive predictive value for SGA were 45, 92.6 and 56.2%, respectively. As PAPP-A MoM values decreased, the odds ratio of having adverse pregnancy outcomes increased.
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Affiliation(s)
- Rachna Agarwal
- 0000 0004 1806 781Xgrid.412444.3Department of Obstetrics and Gynaecology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, 110095 India
| | - Radhika Kumari
- 0000 0004 1806 781Xgrid.412444.3Department of Obstetrics and Gynaecology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, 110095 India
| | - Mohit Mehndiratta
- 0000 0004 1806 781Xgrid.412444.3Department of Biochemistry, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, 110095 India
| | - Gita Radhakrishnan
- 0000 0004 1806 781Xgrid.412444.3Department of Obstetrics and Gynaecology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, 110095 India
| | - M. M. A. Faridi
- 0000 0004 1806 781Xgrid.412444.3Department of Pediatrics, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, 110095 India
| | - Nilesh Chandra
- 0000 0004 1806 781Xgrid.412444.3Department of Biochemistry, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, 110095 India
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Wang H, Bi X, Xu L, Li Y. Negative interference by rheumatoid factor in alpha-fetoprotein chemiluminescent microparticle immunoassay. Ann Clin Biochem 2016; 54:55-59. [PMID: 27073029 DOI: 10.1177/0004563216636646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Rheumatoid factor causes positive interference in multiple immunoassays. Recently, negative interference has also been found in immunoassays in the presence of rheumatoid factor. The chemiluminescent microparticle immunoassay is widely used to determine serum alpha-fetoprotein. However, it is not clear whether the presence of rheumatoid factor in the serum causes interference in the chemiluminescent microparticle immunoassay of alpha-fetoprotein. Methods Serum alpha-fetoprotein was determined using the ARCHITECT alpha-fetoprotein assay. The estimation of alpha-fetoprotein recovery was carried out in samples prepared by diluting high-concentration alpha-fetoprotein serum with rheumatoid factor-positive or rheumatoid factor-negative serum. Paramagnetic microparticles coated with hepatitis B surface antigen-anti-HBs complexes were used to remove rheumatoid factor from the serum. Results The average recovery of alpha-fetoprotein was 88.4% and 93.8% in the rheumatoid factor-positive and rheumatoid factor-negative serum samples, respectively. The recovery of alpha-fetoprotein was significantly lower in the rheumatoid factor-positive serum samples than in the rheumatoid factor-negative serum samples. In two of five rheumatoid factor-positive samples, a large difference was found (9.8%) between the average alpha-fetoprotein recoveries in the serially diluted and initial recoveries. Fourteen rheumatoid factor-positive serum samples were pretreated with hepatitis B surface antigen-anti-HBs complex-coated paramagnetic microparticles. The alpha-fetoprotein concentrations measured in the pretreated samples increased significantly. Conclusions It was concluded that the alpha-fetoprotein chemiluminescent microparticle immunoassay is susceptible to interference by rheumatoid factor, leading to significantly lower results. Eliminating the incidence of negative interference from rheumatoid factor should be an important goal for immunoassay providers. In the meantime, laboratorians must remain alert to the negative interference by rheumatoid factor, and in some cases, pretreat rheumatoid factor-positive samples with blocking or absorbing reagents.
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Affiliation(s)
- Hui Wang
- 1 Department of Laboratory Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohui Bi
- 1 Department of Laboratory Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Xu
- 1 Department of Laboratory Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yirong Li
- 2 Department of Laboratory Medicine, Zhongnan Hospital, Wuhan University, Wuhan, China
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Akkurt MO, Akkurt I, Altay M, Coskun B, Erkaya S, Sezik M. Maternal serum ferritin as a clinical tool at 34-36 weeks' gestation for distinguishing subgroups of fetal growth restriction. J Matern Fetal Neonatal Med 2016; 30:452-456. [PMID: 27049175 DOI: 10.1080/14767058.2016.1174997] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare maternal ferritin levels across pregnancies with fetal growth restriction including SGA and IUGR compared to appropriate for gestational age (AGA). METHODS Three groups were enrolled: AGA, SGA (birth weight below 10th percentile for gestational age with no placental insufficiency findings), and IUGR (birth weight below 5th percentile for gestational age accompanied by abnormal umbilical artery Doppler waveforms and/or oligohydramnios). Maternal serum ferritin samples were obtained at gestational weeks 34 through 36, and delivery occurred at or beyond 36 weeks. RESULTS A total of 126 pregnancies with AGA (36%), SGA (40%), and IUGR (24%) were enrolled. The mean maternal serum ferritin level was higher in the IUGR group than in the AGA group (59 μg/l versus 32.5 μg/l, p < 0.001). A maternal serum ferritin cutoff of 48 μg/l was found to be optimal for distinguishing between IUGR and AGA with a sensitivity of 67.7%, specificity of 92%, PPV of 84%, NPV of 82%, diagnostic accuracy of 82.7%, LR + of 8 and LR- of 0.3, respectively. CONCLUSION Maternal serum ferritin levels differ in pregnancies with IUGR. The role of maternal serum ferritin measurements as a clinical tool for distinguishing different forms of fetal growth restriction warrants further investigation.
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Affiliation(s)
- Mehmet Ozgur Akkurt
- a Department of Obstetrics and Gynecology , Division of Perinatology, Faculty of Medicine, Suleyman Demirel University , Isparta , Turkey
| | - Iltac Akkurt
- b Department of Obstetrics and Gynecology , Isparta Maternity and Children's Hospital , Isparta , Turkey
| | - Metin Altay
- c Department of Obstetrics and Gynecology , Etlik Zubeyde Hanim Maternity and Women's Health Teaching and Research Hospital , Ankara , Turkey , and
| | - Bora Coskun
- c Department of Obstetrics and Gynecology , Etlik Zubeyde Hanim Maternity and Women's Health Teaching and Research Hospital , Ankara , Turkey , and
| | - Salim Erkaya
- d Department of Obstetrics and Gynecology , Zekai Tahir Burak Maternity and Women's Health Teaching and Research Hospital , Ankara , Turkey
| | - Mekin Sezik
- a Department of Obstetrics and Gynecology , Division of Perinatology, Faculty of Medicine, Suleyman Demirel University , Isparta , Turkey
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