Second- and third-trimester serum levels of growth-differentiation factor-15 in prediction of pre-eclampsia

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Wertaschnigg, D
Rolnik, DL
Nie, G
Teoh, SSY
Syngelaki, A
da Silva Costa, F
Nicolaides, KH
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2020
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Abstract

Objective: Pre-eclampsia (PE) is a significant contributor to adverse maternal and perinatal outcome; however, accurate prediction and early diagnosis of this condition remain a challenge. The aim of this study was to compare serum levels of growth-differentiation factor-15 (GDF-15) at three different gestational ages between asymptomatic women who subsequently developed preterm or term PE and healthy controls. Methods: This was a case–control study drawn from a prospective observational study on adverse pregnancy outcomes in women attending for their routine second- and third-trimester hospital visits. Serum GDF-15 was determined in 300 samples using a commercial GDF-15 enzyme-linked immunosorbent assay: 120 samples at 19–24 weeks of gestation, 120 samples at 30–34 weeks and 60 samples at 35–37 weeks. Multiple linear regression was applied to logarithmically transformed GDF-15 control values to evaluate the influence of gestational age at blood sampling and maternal characteristics on GDF-15 results. GDF-15 multiples of the normal median (MoM) values, adjusted for gestational age and maternal characteristics, were compared between pregnancies that subsequently developed preterm or term PE and healthy controls. Results: Values of GDF-15 increased with gestational age. There were no significant differences in GDF-15 MoM values between cases of preterm or term PE and normotensive pregnancies at 19–24 or 35–37 weeks of gestation. At 30–34 weeks, GDF-15 MoM values were significantly increased in cases of preterm PE, but not in those who later developed term PE. Elevated GDF-15 MoM values were associated significantly with a shorter interval between sampling at 30–34 weeks and delivery with PE (P = 0.005). Conclusion: Serum GDF-15 levels at 19–24 or 35–37 weeks of gestation are not predictive of preterm or term PE. At 30–34 weeks, GDF-15 levels are higher in women who subsequently develop preterm PE; however, this difference is small and GDF-15 is unlikely to be useful in clinical practice when used in isolation. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

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Ultrasound in Obstetrics and Gynecology

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56

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6

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© 2020 ISUOG. This is the peer reviewed version of the following article: Second- and third-trimester serum levels of growth-differentiation factor-15 in prediction of pre-eclampsia, Ultrasound in Obstetrics and Gynecology, 2020, 56 (6), pp. 879-884, which has been published in final form at https://doi.org/10.1002/uog.22070. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)

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Subject

Paediatrics

Reproductive medicine

GDF-15

biomarker

growth-differentiation factor-15

pre-eclampsia

prediction

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Wertaschnigg, D; Rolnik, DL; Nie, G; Teoh, SSY; Syngelaki, A; da Silva Costa, F; Nicolaides, KH, Second- and third-trimester serum levels of growth-differentiation factor-15 in prediction of pre-eclampsia, Ultrasound in Obstetrics and Gynecology, 2020, 56 (6), pp. 879-884

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