Prediction of preeclampsia by placental protein 13 and background risk factors and its prevention by aspirin
-
Hamutal Meiri
, Marei Sammar
, Ayelet Herzog , Yael-Inna Grimpel , Galina Fihaman , Aliza Cohen , Vered Kivity , Adi Sharabi-Nov and Ron Gonen
Abstract
Aim: Evaluation of placental protein 13 (PP13) and risk factors (RFs) as markers for predicting preeclampsia (PE) and use of aspirin for PE prevention.
Materials and methods: First-trimester pregnancy screening was based on having PP13 level ≤0.4 multiple of the median (MoM) and/or at least one major risk factor (RF) for PE. Management was by routine care or combined with daily treatment with 75 mg aspirin between 14 and 35 weeks of gestation.
Results: Of 820 deliveries, 63 women developed PE (7.7%). Median PP13 levels was 0.2MoM in the PE group compared with 0.83MoM among unaffected and 1.0MoM in unaffected not treated with aspirin (P<0.0001). Low PP13 was a better predictor for PE versus major RFs, particularly for young nuliparous. Combining low PP13 with RFs increased prediction accuracy. Mean arterial pressure (not included in the initial prediction), could add to prediction accuracy when combined with low PP13 and RFs. PE prevention by aspirin was most effective when the risk was determined by low PP13 alone, less effective for combining low PP13 with RFs, and ineffective when determined by RFs alone.
Conclusion: When PE risk is determined by low first trimester PP13 or by combined low PP13 and RFs, prevention with aspirin is warranted.
Acknowledgements
The authors wish to thank Dr. Ruti Cohen and the Hy-Laboratory team for their assistance in collecting the pregnancy outcomes. We also thank Zer Hi-Tech and American Medical Laboratories for performing the PP13 testing and improving test accuracy. The authors also wish to thank all former employees of Diagnostic Technologies for their valuable assistance in making the kits and all the support they provided in many ways. The preparation of this manuscript was sponsored in part by the EC FP7 project ASPRE (#601852.)
Conflict of interest statement
Author’s conflict of interest disclosure: A.H. used to be an employee of and H.M. is currently a consultant of Hy Laboratories, which acquired the rights to use the PP13 technology. H.M., G.F., M.S., V.K., A.C., and Y-I.G. were employees of the former owner of PP13 technologies until the company stopped its operation in September 2010. They then volunteered time and efforts to the continuation of the clinical service until February 2011.
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©2014 by De Gruyter
Articles in the same Issue
- Frontmatter
- Editorial
- The CROWN Initiative: journal editors invite researchers to develop core outcomes in women’s health
- Academy’s Corner
- Invasive or non-invasive prenatal genetic diagnosis?
- Original articles - Obstetrics
- Effect of depth on shear-wave elastography estimated in the internal and external cervical os during pregnancy
- Analysis of measurement process of placental volume in early pregnancy: an interobserver reliability study
- Acute pancreatitis in pregnancy: a comparison of associated conditions, treatments and complications
- Cesarean section and placental disorders in subsequent pregnancies – a meta-analysis
- Effect of magnesium sulfate and nifedipine on the risk of developing pulmonary edema in preterm births
- Prediction of preeclampsia by placental protein 13 and background risk factors and its prevention by aspirin
- Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol
- Comparison of placental alpha microglobulin-1 in vaginal fluid with intra-amniotic injection of indigo carmine for the diagnosis of rupture of membranes
- Clinical differences between early- and late-onset severe preeclampsia and analysis of predictors for perinatal outcome
- Maternal serum placental growth factor and fetal SGA in pregnancy complicated by type 1 diabetes mellitus
- Original article – Fetus
- Imaging of fetal thymus in pregnant women with rheumatic diseases
- Original articles – Newborn
- Milk demystified by chemistry
- Absence of antibodies against Bordetella pertussis in pregnant women and newborns in the state of Nuevo Leon
- Mortality among sons of female dental personnel – a national cohort study
- IAPM Statements 2005–2012
- DECLARATIONS of the “International Academy of Perinatal Medicine” (IAPM)
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Editorial
- The CROWN Initiative: journal editors invite researchers to develop core outcomes in women’s health
- Academy’s Corner
- Invasive or non-invasive prenatal genetic diagnosis?
- Original articles - Obstetrics
- Effect of depth on shear-wave elastography estimated in the internal and external cervical os during pregnancy
- Analysis of measurement process of placental volume in early pregnancy: an interobserver reliability study
- Acute pancreatitis in pregnancy: a comparison of associated conditions, treatments and complications
- Cesarean section and placental disorders in subsequent pregnancies – a meta-analysis
- Effect of magnesium sulfate and nifedipine on the risk of developing pulmonary edema in preterm births
- Prediction of preeclampsia by placental protein 13 and background risk factors and its prevention by aspirin
- Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol
- Comparison of placental alpha microglobulin-1 in vaginal fluid with intra-amniotic injection of indigo carmine for the diagnosis of rupture of membranes
- Clinical differences between early- and late-onset severe preeclampsia and analysis of predictors for perinatal outcome
- Maternal serum placental growth factor and fetal SGA in pregnancy complicated by type 1 diabetes mellitus
- Original article – Fetus
- Imaging of fetal thymus in pregnant women with rheumatic diseases
- Original articles – Newborn
- Milk demystified by chemistry
- Absence of antibodies against Bordetella pertussis in pregnant women and newborns in the state of Nuevo Leon
- Mortality among sons of female dental personnel – a national cohort study
- IAPM Statements 2005–2012
- DECLARATIONS of the “International Academy of Perinatal Medicine” (IAPM)
- Congress Calendar
- Congress Calendar