ResearchObstetricsAngiopoietin 1 and 2 serum concentrations in first trimester of pregnancy as biomarkers of adverse pregnancy outcomes
Section snippets
Study population and sample testing
This cohort study was conducted on women attending first trimester Down syndrome screening between July 2006 and June 2007 in New South Wales (NSW), Australia. Serum samples were collected by the Pacific Laboratory Medicine Services, and then archived and stored at −80°C. During this period, this was the state's only public screening service and received samples from throughout NSW.
Serum samples for this study were thawed and serum levels of Ang-1 and Ang-2 were measured by a semiautomated
Results
A total of 5183 samples were tested with health information relevant to the pregnancy available for 4785 (92.3%) samples. We excluded 164 women whose blood sample was taken before 10 or after 14 weeks' gestation; had a medical abortion, had a twin pregnancy, or had an infant with a major congenital anomaly. Ang-1 and Ang-2 were undetectable in 111 and 52 samples, respectively, and these women were assigned a value equal to half the detection limit. A total of 4621 women were included in the
Comment
We have conducted the largest population-based study to examine maternal Ang-1 and Ang-2 levels of women in first trimester, and to assess the association with adverse pregnancy outcomes. Our study highlights that Ang-1 and Ang-2 are positively correlated and there is significant variation in Ang-1 and Ang-2 levels, and the Ang-1/Ang-2 ratio by maternal characteristics and week of sampling. Women who developed adverse pregnancy outcomes had lower serum levels of Ang-2 and higher levels of the
Acknowledgments
We thank the NSW Ministry of Health for access to the population health data and the NSW Centre for Health Record Linkage for record linkage and Samantha Lain for preparation of data for linkage. N.N., C.A., J.M. and C.R. conceived the study. N.N., C.A., J.M. and C.R. obtained the funding. N.N., V.T., J.M. and C.R. acquired the data. C.G. performed the laboratory analysis. F.S. and N.N. conducted the statistical analysis. F.S. and N.N. drafted the manuscript, which was approved by all authors.
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The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis
2017, American Journal of Obstetrics and GynecologyCitation Excerpt :As for the need of a minimum dose of aspirin, previous observational studies reported that in a high proportion of women a dose of <100 mg/d is not sufficient to affect platelet function or reduce PE.11-14 The clinical impact of such finding is important because maternal history and characteristics, maternal nutritional status, as well as several ultrasound and biochemical markers can identify women who will develop PE, severe PE, early-onset PE, and FGR before the first symptoms, and as early as the first trimester of pregnancy.79-96 Combined screening by maternal factors, uterine artery pulsatility index, mean arterial pressure, and placental growth factor in the first trimester has been associated with a detection rate of 75% of preterm PE and 47% of PE at a false-positive rate of 10%.97
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2016, American Journal of Obstetrics and GynecologyCitation Excerpt :Others also have documented an antiangiogenic state in pregnancies resulting from in vitro fertilization,23 obesity,24 twin transfusion syndrome,25 and invasive placentation.26 Moreover, there is evidence that antiangiogenic agents in maternal serum may serve as potential biomarkers for subsequent recognition of fetal growth compromise and adverse pregnancy outcomes.27-29 These angiogenic mediators in maternal circulation are predominantly of placental origin.
The authors report no conflict of interest.
This work was funded by Australian National Health and Medical Research Council (NHMRC) Project Grant number 632653 and Centre for Research Excellence Grant number 1001066. NN is supported by an NHMRC Career Development Fellowship (#632955) and CLR by a NHMRC Senior Research Fellowship (#1021025). NHMRC had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Cite this article as: Schneuer FJ, Roberts CL, Ashton AW, et al. Angiopoietin 1 and 2 serum concentrations in first trimester of pregnancy as biomarkers of adverse pregnancy outcomes. Am J Obstet Gynecol 2014;210:345.e1-9.