Journal article
Serum and urine inhibin A but not free activin A are endocrine biomarkers of severe pre-eclampsia
American journal of obstetrics and gynecology, Vol.195(6), pp.1636-1645
12/01/2006
DOI: 10.1016/j.ajog.2006.05.019
PMID: 16959203
Abstract
Objective: Elevation of total serum inhibin A and activin A has been interpreted as evidence of placental dysfunction in women who develop pre-eclampsia. We sought to evaluate serum and urine levels of inhibin A and free activin A in normal and hypertensive pregnancies. Study design: Inhibin A and free activin A were measured by immunoassay in simultaneously collected serum and urine samples from 75 women: (1) severe pre-eclampsia (n = 30); (2) mild pre-eclampsia (n = 11); (3) chronic hypertension (n = 9); (4) pregnant control women (n = 16); and (5) nonpregnant control women (n = 9). Urine levels were normalized to milligrams urine creatinine, and fractional excretions were calculated. Results: Serum and urine inhibin A were increased and fractional excretion was decreased in pregnancy. Serum, urine, and fractional excretion of inhibin A were increased in severe pre-eclampsia, compared with other gravidas. The only difference observed in free activin A was a decrease in serum free activin A in chronic hypertension, compared with severe pre-eclampsia and pregnant control women. Urine inhibin A showed the greatest discrimination between severe pre-eclampsia and pregnant control women: a cut-off of 45 pg/mg urine creatinine had 96.8% sensitivity, 87.5% specificity, and 93.6% accuracy. Women with urine inhibin A greater than 90 pg/mg urine creatinine had a 17-fold relative risk (95% confidence interval 9.7-459.5) of a clinically indicated delivery due to pre-eclampsia. Conclusion: Serum and urine levels of inhibin A are altered in severe pre-eclampsia. Urine inhibin A may have application in the diagnosis and management of pre-eclampsia. Those with chronic hypertension have lower serum but not urine free activin A levels, compared with severe pre-eclampsia and mild pre-eclampsia. © 2006 Mosby, Inc. All rights reserved.
Details
- Title: Subtitle
- Serum and urine inhibin A but not free activin A are endocrine biomarkers of severe pre-eclampsia
- Creators
- Benjamin D. Hamar - Yale UniversityIrina A. Buhimschi - Yale UniversityAnna K. Sfakianaki - Yale UniversityChristian M. Pettker - Yale UniversityLissa K. Magloire - Yale UniversityEdmund F. Funai - Yale UniversityJoshua A. Copel - Yale UniversityCatalin S. Buhimschi - Yale University
- Resource Type
- Journal article
- Publication Details
- American journal of obstetrics and gynecology, Vol.195(6), pp.1636-1645
- DOI
- 10.1016/j.ajog.2006.05.019
- PMID
- 16959203
- NLM abbreviation
- Am J Obstet Gynecol
- ISSN
- 0002-9378
- eISSN
- 1097-6868
- Number of pages
- 10
- Language
- English
- Date published
- 12/01/2006
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9985244665202771
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