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Clin Chim Acta. 2018 Jan;476:160-166. doi: 10.1016/j.cca.2017.11.031. Epub 2017 Nov 27.

First trimester serum afamin concentrations are associated with the development of pre-eclampsia and gestational diabetes mellitus in pregnant women.

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Department of Gynecology and Obstetrics, Danube Hospital, Vienna, Austria.
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Austria.
Department of Nuclear Medical Diagnostics and Therapy, Danube Hospital, Vienna, Austria.
Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria; Vitateq Biotechnology GmbH, Innsbruck, Austria. Electronic address:



Aim of this study was to assess the prognostic capability of afamin to predict pregnancy complications.


First-trimester screening was consecutively performed in 4948 pregnant women, of whom 474 women developed pregnancy complications [gestational hypertension (n=84), pre-eclampsia (n=30), intrauterine growth restriction (n=107), preterm birth (n=44), and gestational diabetes mellitus (n=209)]. To each woman with pregnancy complications an uncomplicated pregnancy was matched for body mass index. Afamin serum concentrations were measured in 948 pregnant women at the first-trimester screening.


Median afamin concentrations were significantly higher in women developing pre-eclampsia or gestational diabetes mellitus when compared to women with uncomplicated pregnancies (76mg/L vs. 65mg/L, p=0.001 and 80mg/L vs. 69mg/L, p<0.001). There was no difference in median afamin values between all other pregnancy complications and their matched controls. Increased afamin (i.e. >65mg/L) was a strong and independent predictor for the development of pre-eclampsia (risk ratio, 24.58; 95%CI, 2.82-214.12; p=0.004) as well as gestational diabetes mellitus (risk ratio, 2.07; 95%CI, 1.33-3.22; p=0.001).


In this large nested case-control study increased afamin concentrations were a strong and independent predictor for pre-eclampsia and gestational diabetes mellitus, suggesting a potential role of afamin as predictive marker for pregnancy-related metabolic disorders.


Afamin; Gestational diabetes mellitus; Pre-eclampsia; Pregnancy complications

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