Abstract:

Objective  To determine the maternal, umbilical cord serum alterations and placental pregnancy-associated plasma protein-A (PAPP-A) in preeclampsia (PE) and healthy pregnancies to assess if there is association between maternal and umbilical cord serum PAPP-A levels and umbilical artery systolic/diastolic (S/D) ratio in preeclampsia. Methods  52 pregnant women with PE were divided into early-onset group (n=30, onset time ≤ 32 gestational weeks) and late-onset group (n=22, onset time > 32 gestational weeks). 28 healthy pregnant women were included as control 1 (n=14, gestational age ≤ 32 weeks) and control 2 (n=14, gestational age > 32 weeks). Doppler velocimetry of umbilical artery systolic/diastolic (S/D) ratio was obtained in all fetuses. Enzyme-linked immunosorbent assay (ELISA) was used to detect the maternal and umbilical cord serum level of PAPP-A. Immunohistochemistry was used to detect placental PAPP-A expression. Results  ① The maternal serum PAPP-A in early-onset and late-onset PE groups was significantly higher than that in control 1 and control 2 (P<0.05), and it was higher in the early-onset PE group than that in the late-onset PE group (P<0.05). The umbilical serum PAPP-A in early-onset and late-onset PE groups was significantly higher than that in control 2 (P<0.05). ② The placental PAPP-A in early-onset PE group was significantly higher than that in late-onset PE group and control 2 (P>0.05). ③ The umbilical artery S/D ratio in early-onset and late-onset PE groups was significantly higher than that in control 1 and control 2 (P<0.05), and it′s higher in early-onset PE group than that in late-onset group (P<0.05). ④ The maternal serum PAPP-A was positively correlated with  umbilical artery S/D in early-onset PE group (P<0.05). Conclusion  Maternal serum PAPP-A level and umbilical artery S/D ratio are elevated in early-onset PE pregnancies. There is a positive correlation between maternal PAPP-A and umbilical artery S/D ratio in early-onset PE, indicating a possible connection with prognosis of early-onset preeclampsia.

Key words: Pregnancy-associated plasma protein-A; Early-onset preeclampsia; Umbilical artery S/D; Umbilical blood