Second and third trimester serum levels of growth‐differentiation factor‐15 in the prediction of pre‐eclampsia

Dagmar Wertaschnigg, Daniel L. Rolnik, Guiying Nie, Sonia Teoh, Argyro Syngelaki, Fabricio A. Da Silva Costa, Kypros H Nicolaides

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background
Pre‐eclampsia (PE) is a significant contributor to maternal and perinatal adverse outcome, however accurate prediction and early diagnosis of this condition remain a challenge.

Objectives
To compare serum levels of growth‐differentiation factor 15 (GDF‐15) at three different gestational ages between asymptomatic women who subsequently developed preterm or term PE and healthy controls.

Methods
This was a case‐control study drawn from a prospective observational study for adverse pregnancy outcomes in women attending for their routine second and third trimester hospital visits. Serum GDF‐15 was determined in 300 samples using a commercial GDF‐15 enzyme‐linked immunosorbent assay: 120 samples at 19‐24 weeks of gestation, 120 samples at 30‐34 weeks and 60 samples at 35‐37 weeks. Multiple linear regression was applied on logarithmically transformed GDF‐15 control values to evaluate the influence of gestational age at blood sampling and maternal characteristics on GDF‐15 results. Multiples of the normal median (MoM) GDF‐15 values, adjusted for gestational age and maternal characteristics, were compared between the PE group and healthy controls.

Results
Values of GDF‐15 increased with gestational age. There were no significant differences in GDF‐15 values between cases of preterm or term PE and normotensive pregnancies at 19‐24 or 35‐37 weeks of gestation. At 30‐34 weeks, GDF‐15 MoM values were significantly increased in cases of preterm PE, but not in those who later developed term PE. Elevated GDF‐15 MoM values were significantly associated with a shorter interval between sampling at 30‐34 weeks and delivery with PE (P=0.005).

Conclusion
Serum GDF‐15 levels at 19‐24 or 35‐37 weeks of gestation are not predictive of preterm or term PE. At 30‐34 weeks, GDF‐15 levels are higher in women who subsequently develop pre‐eclampsia; however, this difference is small and GDF‐15 is unlikely to be useful in clinical practice when used in isolation.
Original languageEnglish
Number of pages31
JournalUltrasound in Obstetrics & Gynecology
DOIs
Publication statusAccepted/In press - 10 May 2020

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