Sammya Bezerra Maia E Holanda Moura1,2,3, Felicity Park4, Padma Murthi5, Wellington P Martins6, Stefan C Kane3,7, Paul Williams4, Jonathan Hyett4,8, Fabrício da Silva Costa3,7,9. 1. a School of Medicine, University of Fortaleza (UNIFOR) , Ceará , Brazil . 2. b Department of Public Health , State University of Ceará , Fortaleza , Ceará , Brazil . 3. c Department of Perinatal Medicine , Royal Women's Hospital , Melbourne , Victoria , Australia . 4. d Central Clinical School, University of Sydney , Sydney , New South Wales , Australia . 5. e Northwest Academic Centre, University of Melbourne , Victoria , Australia . 6. f Department of Obstetrics and Gynecology , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , São Paulo , Brazil . 7. g Department of Obstetrics and Gynaecology , University of Melbourne , Victoria , Australia . 8. h RPA Women and Babies, Royal Prince Alfred Hospital , Sydney , New South Wales , Australia , and. 9. i Monash Ultrasound for Women , Melbourne , Victoria , Australia.
Abstract
OBJECTIVE: To examine whether the maternal serum concentration of the soluble receptor-1 of tumor necrosis factor-α (TNF-R1) at 11-13 + 6 weeks of gestation is a predictor of development of pre-eclampsia (PE). METHODS: This is a nested case-control study in which the concentration of TNF-R1 at 11 + 0 to 13 + 6 weeks was measured in 426 pregnant women in the first trimester. TNF-R1 values were expressed as multiples of the median (MoM) adjusted for maternal factors. The distributions of log TNF-R1 MoM in the control group and hypertensive disorders (early-PE [ePE], late-PE [lPE] and gestational hypertension [GH]) groups were compared. Logistic regression analysis was used to determine whether maternal factors, TNF-R1 or their combination make a significant contribution to the prediction of PE. Screening performance was determined by analysis of receiver-operating characteristics curves. RESULTS: Median concentration of TNF-R1 (ng/ml) was higher in ePE (2.62 ± 0.67), lPE (2.12 ± 0.56) and GH (2.19 ± 0.45) compared to controls (2.04 ± 0.42), p = 0.001. Logistic regression analysis demonstrated that the addition of TNFR-1 to maternal factors did not make a significant contribution to the prediction of PE. CONCLUSIONS: The maternal serum TNF-R1 concentration at 11-13 + 6 weeks of gestation was increased in pregnancies which developed hypertensive disorders, however, the addition of TNFR-1 did not improve the detection rate of these conditions compared with maternal factors alone.
OBJECTIVE: To examine whether the maternal serum concentration of the soluble receptor-1 of tumor necrosis factor-α (TNF-R1) at 11-13 + 6 weeks of gestation is a predictor of development of pre-eclampsia (PE). METHODS: This is a nested case-control study in which the concentration of TNF-R1 at 11 + 0 to 13 + 6 weeks was measured in 426 pregnant women in the first trimester. TNF-R1 values were expressed as multiples of the median (MoM) adjusted for maternal factors. The distributions of log TNF-R1 MoM in the control group and hypertensive disorders (early-PE [ePE], late-PE [lPE] and gestational hypertension [GH]) groups were compared. Logistic regression analysis was used to determine whether maternal factors, TNF-R1 or their combination make a significant contribution to the prediction of PE. Screening performance was determined by analysis of receiver-operating characteristics curves. RESULTS: Median concentration of TNF-R1 (ng/ml) was higher in ePE (2.62 ± 0.67), lPE (2.12 ± 0.56) and GH (2.19 ± 0.45) compared to controls (2.04 ± 0.42), p = 0.001. Logistic regression analysis demonstrated that the addition of TNFR-1 to maternal factors did not make a significant contribution to the prediction of PE. CONCLUSIONS: The maternal serum TNF-R1 concentration at 11-13 + 6 weeks of gestation was increased in pregnancies which developed hypertensive disorders, however, the addition of TNFR-1 did not improve the detection rate of these conditions compared with maternal factors alone.
Authors: Linda Jacqueline Elisabeth Meertens; Hubertina Cj Scheepers; Raymond G De Vries; Carmen D Dirksen; Irene Korstjens; Antonius Lm Mulder; Marianne J Nieuwenhuijze; Jan G Nijhuis; Marc Ea Spaanderman; Luc Jm Smits Journal: JMIR Res Protoc Date: 2017-10-26