First trimester serum apolipoproteins in the prediction of late-onset preeclampsia

Abstract

Late-onset preeclampsia occurring after 34 weeks of gestation is the most common form of preeclampsia, but little is known about either etiology or prevention. Current detection methods for preeclampsia in early pregnancy have not shown promising results in detecting late-onset preeclampsia. The aim of this study was to assess whether apolipoproteins in combination with maternal medical history and biophysical factors can be used as an early detection method for late-onset preeclampsia. This nested case-cohort study was based at Odense University Hospital, Denmark. Women attending their first trimester scan were invited to participate if they understood Danish or English, were above the age of 18, and had singleton pregnancies. Blood pressure, maternal medical history, uterine artery pulsatility indices, and blood samples were collected at inclusion. Outcome data were collected from participants’ medical files postpartum, and cases were selected when preeclampsia diagnostics were present. Serum samples were analyzed by targeted mass spectrometry using a biomarker panel consisting of 12 apolipoproteins. Logistic regression analyses were performed and finally receiver operating curves were completed. The cohort consisted of 27 cases and 194 normotensive controls, randomized from 340 eligible participants. Significant differences were found between the two groups’ baseline characteristics but none of the apolipoproteins showed significant difference (p < 0.05). The ROC-curve combining maternal characteristics, mean arterial pressure and two apolipoproteins showed the best sensitivity of 55.5% at a 10% false-positive rate and an area under the curve of 0.873. In conclusion, apolipoproteins did not improve the detection of late-onset preeclampsia in a combined screening model.

Keywords:

• Preeclampsia
• late-onset preeclampsia
• first-trimester screening
• apolipoproteins
• targeted proteomics
• MRM-MS

Acknowledgements

The authors thank the sonographers at Department of Obstetrics and Gynecology for performing all uterine artery Doppler measurements for this study as well as the technical staff at the Biomarker Research Unit, Department of Clinical Biochemistry, Odense University Hospital.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the research organization OPEN, Open Patient data Explorative Network, Odense University Hospital, Region of Southern Denmark, particularly the affiliations OPEN Biobank and OPEN Statistics. This work was supported by the OUH Free Research Fund, grant no. 72-A3727 to MO.