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Transfusion. 2013 Sep;53(9):1956-64. doi: 10.1111/trf.12073. Epub 2013 Jan 16.

Identifying mild and severe preeclampsia in asymptomatic pregnant women by levels of cell-free fetal DNA.

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  • 1Department of Fetal Medicine, 4002, Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Immunology, 2034, Diagnostic Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Abstract

BACKGROUND:

The objective was to investigate whether women who develop preeclampsia can be identified in a routine analysis when determining fetal RHD status at 25 weeks' gestation in combination with PAPP-A levels at the first-trimester combined risk assessment for Trisomy 21.

STUDY DESIGN AND METHODS:

D- women participating in the routine antenatal RHD screening program in the capital region of Denmark were retrospectively studied. We used a standard dilution curve to quantify the amounts of cell-free fetal DNA (cffDNA) and divided women into groups according to cffDNA levels. PAPP-A was measured at 11 to 14 weeks. Information about pregnancy outcome and complications was obtained from the National Fetal Medicine Database, medical charts, and discharge letters.

RESULTS:

The odds ratio (OR) of developing severe preeclampsia given a cffDNA level above the 90th percentile compared to cffDNA below the 90th percentile was 8.1 (95% confidence interval [CI], 2.6-25.5). The OR of developing mild preeclampsia given a cffDNA level below the 5th percentile compared to cffDNA levels above the 5th percentile was 3.6 (95% CI, 1.1-11.7). PAPP-A levels below the 5th percentile were associated with mild preeclampsia, but adding it to the analysis did not increase the detection rate (DR).

CONCLUSION:

Women with cffDNA levels below the 5th percentile and above the 90th percentile quantified at 25 weeks' gestation are at increased risk of developing preeclampsia. Adding PAPP-A levels to the analysis did not increase the DR of preeclampsia.

© 2013 American Association of Blood Banks.

[PubMed - indexed for MEDLINE]
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