Analytes to be the better predictors of adverse pregnancy outcome

 Significant links have been found between maternal serum levels of analytes evaluated early in pregnancy and subsequent adverse pregnancy outcomes in nulliparous gravidas or women who have not given birth previously.

Yet they cannot be used as clinical biomarkers to predict adverse pregnancy outcomes, either alone or in combination with maternal clinical characteristics, the latest study published in AJOG has found.

The study led by Samuel Parry et. al tried to research placental physiology and identify novel biomarkers in relation to adverse pregnancy outcomes, including preterm birth, preeclampsia, small for gestational age (SGA) neonates, and stillbirth.

Maternal serum samples were collected at two study visits (6-13 weeks and 16-21 weeks), and levels of nine analytes were measured.

The analytes measured were vascular endothelial growth factor (VEGF), placental growth factor (PlGF), endoglin (Eng), soluble fms-like tyrosine kinase-1 (sFlt-1), A disintegrin, and metalloproteinase domain-containing protein 12 (ADAM12), pregnancy-associated plasma protein-A (PAPP-A), free β human chorionic gonadotropin (βhCG), inhibin A, and alpha-fetoprotein (AFP).

The primary outcome was preterm birth between 20 weeks 0 days and 36 weeks 6 days gestation. Secondary outcomes were spontaneous preterm births, medically-indicated preterm births, preeclampsia, SGA neonates, and stillbirth.     

A total of 10,038 eligible gravidas were enrolled into the nuMoM2b cohort, from which a nested case-control study was performed comparing 800 cases with preterm birth, 568 with preeclampsia, 406 with SGA birth, and 49 with stillbirth, with 911 controls who delivered at term without complications.