Combination of PAPPA, fhCGβ, AFP, PlGF, sTNFR1, and Maternal Characteristics in Prediction of Early-onset Preeclampsia

Anna Yliniemi; Kaarin Makikallio; Teemu Korpimaki; Heikki Kouru; Jaana Marttala; Markku Ryynanen

doi:10.4137/CMRH.S21865

Combination of PAPPA, fhCGβ, AFP, PlGF, sTNFR1, and Maternal Characteristics in Prediction of Early-onset Preeclampsia

Clin Med Insights Reprod Health. 2015 Jun 11:9:13-20. doi: 10.4137/CMRH.S21865. eCollection 2015.

Authors

Anna Yliniemi¹, Kaarin Makikallio¹, Teemu Korpimaki², Heikki Kouru², Jaana Marttala³, Markku Ryynanen¹

Affiliations

¹ Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland.
² Department of PerkinElmer, Turku, Finland.
³ Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland. ; Department of Dermatology, Thomas Jefferson University, Philadelphia, USA.

Abstract

Objective: To evaluate the efficacy of first-trimester markers-pregnancy-associated plasma protein A (PAPPA), free human chorionic gonadotropin β (fhCGβ), alpha-fetoprotein (AFP), placental growth factor (PlGF), and soluble tumor necrosis factor receptor-1 (sTNFR1) together with maternal characteristics (MC) for prediction of early-onset preeclampsia (EOPE).

Methods: During 2005-2010, the abovementioned biomarkers were analyzed with logistic regression analysis in 64 EOPE and 752 control subjects to determine whether these biomarkers separately and in combination with MC would predict development of EOPE.

Results: PAPPA, fhCGβ, and PlGF levels were lower, whereas AFP and sTNFR1 levels were higher in mothers with EOPE compared to controls. The combination of all markers with MC (age, weight, and smoking status) detected 48% of the mothers with EOPE, with a 10% false-positive rate (FPR).

Conclusions: First-trimester maternal serum levels of PAPPA, fhCGβ, AFP, PlGF, and sTNFR1, together with MC, are predictive of development of subsequent EOPE. These markers, along with MC, form a suitable panel for predicting EOPE.

Keywords: alpha-fetoprotein (AFP); early-onset preeclampsia; free β-subunit of human chorionic gonadotropin (fhCGβ); placental growth factor (PlGF); pregnancy-associated plasma protein A (PAPPA); soluble tumor necrosis factor receptor-1 (sTNFR1).