Next Article in Journal
Fetal Umbilical Vein Flow in the Classification of Fetuses with Growth Restriction
Previous Article in Journal
The Technological Advances in Embryo Selection and Genetic Testing: A Look Back at the Evolution of Aneuploidy Screening and the Prospects of Non-Invasive PGT
Previous Article in Special Issue
Pro- and Anti-Angiogenic Markers as Clinical Tools for Suspected Preeclampsia with and without FGR near Delivery—A Secondary Analysis
Article

Maternal Serum Inhibin-A Augments the Value of Maternal Serum PlGF and of sFlt-1/PlGF Ratio in the Prediction of Preeclampsia and/or FGR Near Delivery—A Secondary Analysis

1
Ziv Medical Center, Safed, and Tel Hai College, Tel Hai 13100, Israel
2
Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Center, Zaloška cesta 2, 1000 Ljubljana, Slovenia
3
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
4
Institute of Clinical Chemistry and Biochemistry, University Medical Centre, Njegoševa 4, 1000 Ljubljana, Slovenia
5
Faculty of Pharmacy, University of Ljubljana, cesta 7, 1000 Ljubljana, Slovenia
6
Women’s Hospital, Prečna ulica 4, 6230 Postojna, Slovenia
7
TeleMarpe Ltd., 41 Beit El St., Tel Aviv 6908742, Israel
8
The Fetal Medicine Research Institute, King’s College Hospital, 16-20 Windsor Walk, London SE5 8BB, UK
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editors: Paolo Ivo Cavoretto and Berthold Huppertz
Reprod. Med. 2021, 2(1), 35-49; https://doi.org/10.3390/reprodmed2010005
Received: 31 December 2020 / Revised: 3 February 2021 / Accepted: 7 February 2021 / Published: 1 March 2021
(This article belongs to the Special Issue Preeclampsia: Pathogenesis, Diagnosis and Treatment)
Objective: We previously provided evidence to confirm that maternal serum levels of soluble Fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and their ratio are useful tools to direct the management of preeclampsia (PE), fetal growth restriction (FGR), and PE+FGR near delivery. In this secondary analysis, we further examine the potential additive value of maternal serum Inhibin-A, which is a hormone marker of the transforming growth factor family, to the accuracy provided by maternal serum PlGF and sFlt-1. Methods: We conducted a secondary analysis where we extracted the data of a cohort of 125 pregnant women enrolled near delivery at the clinics of the University Medical Center of Ljubljana, Slovenia. The dataset included 31 cases of PE, 16 of FGR, 42 of PE+FGR, 15 preterm delivery (PTD), and 21 unaffected controls with delivery of a healthy baby at term. Cases delivered before 34 weeks’ gestation included 10 of PE, 12 of FGR, 28 of PE+FGR, and 6 of PTD. In addition to the recorded demographic characteristics and medical history and the maternal serum levels of PlGF and sFlt-1/PlGF ratio, which were previously published, we evaluated the added value of maternal serum Inhibin-A. The predictive accuracy of each biomarker, their ratios, and combinations were estimated from areas under the curve (AUC) of receiver operating characteristics (ROC) curves, Box and Whisker plots, and by multiple regression. We estimated accuracy by the continuous marker model and a cutoff model. Results: In this study, we combined Inhibin-A with PlGF or with the sFlt-1/PlGF ratio and showed a 10–20% increase in AUCs and 15–45% increase in the detection rate, at 10% false positive rate, of PE, and a lower, but significant, increase for PE+FGR and FGR in all cases but not for FGR in early cases delivered < 34 weeks. The use of a cutoff model was adequate, although a bit higher accuracy was obtained from the continuous model. The highest correlation was found for PlGF with all three complications. Conclusion: In this secondary analysis, we have found that maternal serum Inhibin-A improves the accuracy of predicting PE and PE+FGR provided by maternal serum angiogenic markers alone, bringing the results to a diagnostic level; thus, it could be considered for directing clinical management. Inhibin-A had smaller or no added value for the accuracy of predicting FGR alone, mainly of early cases delivered <34 weeks. View Full-Text
Keywords: preeclampsia; fetal growth restriction; sFlt-1; Inhibin-A; placental growth factor preeclampsia; fetal growth restriction; sFlt-1; Inhibin-A; placental growth factor
Show Figures

Figure 1

MDPI and ACS Style

Sharabi-Nov, A.; Premru Sršen, T.; Kumer, K.; Fabjan Vodušek, V.; Fabjan, T.; Tul, N.; Meiri, H.; Nicolaides, K.H.; Osredkar, J. Maternal Serum Inhibin-A Augments the Value of Maternal Serum PlGF and of sFlt-1/PlGF Ratio in the Prediction of Preeclampsia and/or FGR Near Delivery—A Secondary Analysis. Reprod. Med. 2021, 2, 35-49. https://doi.org/10.3390/reprodmed2010005

AMA Style

Sharabi-Nov A, Premru Sršen T, Kumer K, Fabjan Vodušek V, Fabjan T, Tul N, Meiri H, Nicolaides KH, Osredkar J. Maternal Serum Inhibin-A Augments the Value of Maternal Serum PlGF and of sFlt-1/PlGF Ratio in the Prediction of Preeclampsia and/or FGR Near Delivery—A Secondary Analysis. Reproductive Medicine. 2021; 2(1):35-49. https://doi.org/10.3390/reprodmed2010005

Chicago/Turabian Style

Sharabi-Nov, Adi, Tanja Premru Sršen, Kristina Kumer, Vesna Fabjan Vodušek, Teja Fabjan, Nataša Tul, Hamutal Meiri, Kypros H. Nicolaides, and Joško Osredkar. 2021. "Maternal Serum Inhibin-A Augments the Value of Maternal Serum PlGF and of sFlt-1/PlGF Ratio in the Prediction of Preeclampsia and/or FGR Near Delivery—A Secondary Analysis" Reproductive Medicine 2, no. 1: 35-49. https://doi.org/10.3390/reprodmed2010005

Find Other Styles

Article Access Map by Country/Region

1
Back to TopTop