PAPP‐A2 and inhibin A as novel predictors for pregnancy complications in women with suspected or confirmed preeclampsia
Journal of the American Heart Association Oct 16, 2020
Neuman RI, van der Meer MMA, Nieboer D, et al. - Researchers here investigated the value of inhibin A and PAPP‐A2 (pregnancy‐associated plasma protein‐A2) for predicting preeclampsia‐related complications and determined how these compare with angiogenic biomarkers. They used a secondary analysis of a prospective, multicenter, observational study, aimed at evaluating the utility of sFlt‐1 (soluble Fms‐like tyrosine kinase‐1)/PlGF (placental growth factor) ratio, in order to determine inhibin A and PAPP‐A2 levels in 524 women with suspected/confirmed preeclampsia. Significantly increased levels of inhibin A and PAPP‐A2 were noted in women with preeclampsia and in maternal perfusate of preeclamptic placentas. The prediction of maternal complications improved significantly when inhibin A and PAPP‐A2 were added on top of the traditional criteria; gestational age, parity, proteinuria, and diastolic blood pressure. To differentiate fetal/neonatal complications on top of traditional criteria, inhibin A and PAPP‐A2 exhibited additive value but their discriminative value remained inferior to that of sFlt‐1/PlGF ratio or PlGF. The PAPP‐A2/PlGF ratio alone displayed remarkable predictive value for pregnancy complications, being superior to sFlt‐1/PlGF ratio in the case of maternal complications. Overall, findings suggest significant potential of inhibin A and PAPP‐A2 to predict preeclampsia‐related pregnancy complications and possibility of their beneficial effects on top of the angiogenic markers.
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