Serum concentrations of HE4 and Ca125 in uncomplicated pregnancies: a longitudinal study

Abstract

In this study, we aimed to evaluate the effects of pregnancy on the serum level of HE4. Forty-six singleton pregnant women in the study group and 40 premenopausal women in the control group were included. HE4 and Ca125 levels were measured longitudinally at each trimester of pregnancy in the study group and once in the control group at the recruitment. In total 46, 38 and 33 pregnant patients blood samples were analysed in the first, second and third trimester of pregnancy, respectively. The analysis was performed in 31 of the pregnant patients (31/46, 67.4%) in each trimester of pregnancy. A comparison of the median HE4 levels of control and study group revealed that the first and second trimester levels were significantly lower than the control group (p < .001 and p = .015, respectively). There was no difference between the control group and third trimester median HE4 levels (p = .55).

Impact Statement

• What is already known on this subject? HE4 is a novel tumour marker approved for the detection of ovarian cancer and monitoring the recurrence or disease progression in conjunction with Ca125. However, we do not know much about physiological changes of HE4 level during pregnancy.

• What the results of this study add? The current study showed HE4 decreases during first and second trimesters of pregnancy and does not change during third trimester of pregnancy according to healthy premenopausal women.

• What the implications are of these findings for clinical practice and/or further research? HE4 has a potential to be used in pregnancy but a lower cut off value should be considered in the pregnant population during the first and second trimesters of pregnancy.

Keywords:

• Pregnancy
• biological tumour markers
• creatinine