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Fetal hemoglobin, α1-microglobulin and hemopexin are potential predictive first trimester biomarkers for preeclampsia

DOLBERG ANDERSON, ULRIK LU ; Gram, Magnus LU ; Ranstam, Jonas LU ; Thilaganathan, Basky; Åkerström, Bo LU and Hansson, Stefan R. (2016) In Pregnancy Hypertension 6(2). p.103-109
Abstract

Objective Overproduction of cell-free fetal hemoglobin (HbF) in the preeclamptic placenta has been recently implicated as a new etiological factor of preeclampsia. In this study, maternal serum levels of HbF and the endogenous hemoglobin/heme scavenging systems were evaluated as predictive biomarkers for preeclampsia in combination with uterine artery Doppler ultrasound. Study design Case-control study including 433 women in early pregnancy (mean 13.7 weeks of gestation) of which 86 subsequently developed preeclampsia. The serum concentrations of HbF, total cell-free hemoglobin, hemopexin, haptoglobin and α1-microglobulin were measured in maternal serum. All patients were examined with uterine artery Doppler ultrasound.... (More)

Objective Overproduction of cell-free fetal hemoglobin (HbF) in the preeclamptic placenta has been recently implicated as a new etiological factor of preeclampsia. In this study, maternal serum levels of HbF and the endogenous hemoglobin/heme scavenging systems were evaluated as predictive biomarkers for preeclampsia in combination with uterine artery Doppler ultrasound. Study design Case-control study including 433 women in early pregnancy (mean 13.7 weeks of gestation) of which 86 subsequently developed preeclampsia. The serum concentrations of HbF, total cell-free hemoglobin, hemopexin, haptoglobin and α1-microglobulin were measured in maternal serum. All patients were examined with uterine artery Doppler ultrasound. Logistic regression models were developed, which included the biomarkers, ultrasound indices, and maternal risk factors. Results There were significantly higher serum concentrations of HbF and α1-microglobulin and significantly lower serum concentrations of hemopexin in patients who later developed preeclampsia. The uterine artery Doppler ultrasound results showed significantly higher pulsatility index values in the preeclampsia group. The optimal prediction model was obtained by combining HbF, α1-microglobulin and hemopexin in combination with the maternal characteristics parity, diabetes and pre-pregnancy hypertension. The optimal sensitivity for all preeclampsia was 60% at 95% specificity. Conclusions Overproduction of placentally derived HbF and depletion of hemoglobin/heme scavenging mechanisms are involved in the pathogenesis of preeclampsia. The combination of HbF and α1-microglobulin and/or hemopexin may serve as a prediction model for preeclampsia in combination with maternal risk factors and/or uterine artery Doppler ultrasound.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
preeclampsia, biomarkers, Fetal hemoglobin, α1-microglobulin
in
Pregnancy Hypertension
volume
6
issue
2
pages
7 pages
publisher
Elsevier
external identifiers
  • Scopus:84964330148
ISSN
2210-7789
language
English
LU publication?
yes
id
dec96ccf-77fc-4cc2-8b22-99ba60e74573
date added to LUP
2016-06-16 08:39:02
date last changed
2016-07-07 14:37:39
@misc{dec96ccf-77fc-4cc2-8b22-99ba60e74573,
  abstract     = {<p>Objective Overproduction of cell-free fetal hemoglobin (HbF) in the preeclamptic placenta has been recently implicated as a new etiological factor of preeclampsia. In this study, maternal serum levels of HbF and the endogenous hemoglobin/heme scavenging systems were evaluated as predictive biomarkers for preeclampsia in combination with uterine artery Doppler ultrasound. Study design Case-control study including 433 women in early pregnancy (mean 13.7 weeks of gestation) of which 86 subsequently developed preeclampsia. The serum concentrations of HbF, total cell-free hemoglobin, hemopexin, haptoglobin and α<sub>1</sub>-microglobulin were measured in maternal serum. All patients were examined with uterine artery Doppler ultrasound. Logistic regression models were developed, which included the biomarkers, ultrasound indices, and maternal risk factors. Results There were significantly higher serum concentrations of HbF and α<sub>1</sub>-microglobulin and significantly lower serum concentrations of hemopexin in patients who later developed preeclampsia. The uterine artery Doppler ultrasound results showed significantly higher pulsatility index values in the preeclampsia group. The optimal prediction model was obtained by combining HbF, α<sub>1</sub>-microglobulin and hemopexin in combination with the maternal characteristics parity, diabetes and pre-pregnancy hypertension. The optimal sensitivity for all preeclampsia was 60% at 95% specificity. Conclusions Overproduction of placentally derived HbF and depletion of hemoglobin/heme scavenging mechanisms are involved in the pathogenesis of preeclampsia. The combination of HbF and α<sub>1</sub>-microglobulin and/or hemopexin may serve as a prediction model for preeclampsia in combination with maternal risk factors and/or uterine artery Doppler ultrasound.</p>},
  author       = {DOLBERG ANDERSON, ULRIK and Gram, Magnus and Ranstam, Jonas and Thilaganathan, Basky and Åkerström, Bo and Hansson, Stefan R.},
  issn         = {2210-7789},
  keyword      = {preeclampsia,biomarkers,Fetal hemoglobin,α1-microglobulin },
  language     = {eng},
  month        = {04},
  number       = {2},
  pages        = {103--109},
  publisher    = {ARRAY(0x81fed78)},
  series       = {Pregnancy Hypertension},
  title        = {Fetal hemoglobin, α<sub>1</sub>-microglobulin and hemopexin are potential predictive first trimester biomarkers for preeclampsia},
  volume       = {6},
  year         = {2016},
}