1. Early Prediction of Hypertensive Disorders of Pregnancy Using Cell-Free Fetal DNA, Cell-Free Total DNA, and Biochemical Markers.
- Author
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Kim, Shin Young, Kim, Hyun Jin, Park, So Yeon, Han, Yoo Jung, Choi, June Seek, and Ryu, Hyun Mee
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PREECLAMPSIA diagnosis , *PROTEIN metabolism , *CARDIOVASCULAR diseases in pregnancy , *ALPHA fetoproteins , *CHORIONIC gonadotropins , *DNA , *GESTATIONAL age , *GLYCOPROTEINS , *HYPERTENSION in pregnancy , *POLYMERASE chain reaction , *FIRST trimester of pregnancy , *SECOND trimester of pregnancy , *PREGNANCY proteins , *PRENATAL diagnosis , *PROTEINS , *CASE-control method , *EARLY diagnosis , *ESTRIOL , *EPIGENOMICS , *DIAGNOSIS - Abstract
Objective: To evaluate the predictive value of separate and combined tests using cell-free fetal DNA (cffDNA), cell-free total DNA (cfDNA), and biochemical markers for the early detection of pregnancies with hypertensive disorders.Methods: A nested case-control study was conducted with 135 singleton pregnancies including 17 gestational hypertension cases, 34 preeclampsia (PE) cases, and 84 controls. We performed real-time quantitative PCR to measure levels of DSCR3 and RASSF1A as cffDNA markers and HYP2 as a cfDNA marker in the first and early second trimesters. Levels of pregnancy-associated plasma protein A (PAPP-A), α-fetoprotein, β-human chorionic gonadotropin, unconjugated estriol, and inhibin A were also determined.Results: Compared with controls, the median levels and multiples of the median (MoM) values of HYP2 were significantly higher in the PE and hypertensive disorders of pregnancy (HDP) groups at 6-14 and 15-23 weeks. Frist-trimester PAPP-A MoM was significantly lower in PE and HDP than in controls. For PE and HDP, the best model included the first-trimester DSCR3, HYP2, and PAPP-A MoM values achieving detection rates of 67 and 58% at a fixed 10% false-positive rate, respectively [area under the receiver operating characteristic curve 0.832 (95% CI 0.689-0.928) for PE; 0.751 (0.607-0.863) for HDP].Discussion: The study demonstrates the potential utility of combined first-trimester cffDNA, cfDNA, and PAPP-A for the early prediction of PE. [ABSTRACT FROM AUTHOR]- Published
- 2016
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