Maternal serum glycosylated fibronectin as a point-of-care biomarker for assessment of preeclampsia - 18/09/14

Doi : 10.1016/j.ajog.2014.07.052

Juha Rasanen, MD, PhD ^a,^c, Matthew J. Quinn, PhD ^b, Amber Laurie, MS ^b, Eric Bean, PhD ^b, Charles T. Roberts, PhD ^b, Srinivasa R. Nagalla, MD ^b, Michael G. Gravett, MD ^d,^⁎
^a Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR
^b DiabetOmics Inc, Hillsboro, OR
^c Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, and Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
^d Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA

^∗Corresponding author: Michael G. Gravett, MD.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 18 September 2014
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Abstract

Objective

We assessed the association of glycosylated fibronectin (GlyFn) with preeclampsia and its performance in a point-of-care (POC) test.

Study Design

GlyFn, placental growth factor (PlGF), and soluble vascular endothelial growth factor receptor 1 (sFlt1) levels were determined in serum samples from 107 pregnant women. In all, 45 were normotensive and 62 were diagnosed with preeclampsia. The ability of GlyFn to assess preeclampsia status and relationships between GlyFn and maternal characteristics and pregnancy outcomes were analyzed.

Results

GlyFn serum levels in the first trimester were significantly higher in women with preeclampsia (P < .01) and remained higher throughout pregnancy (P < .01). GlyFn, sFlt1, PlGF, and the sFlt1/PlGF ratio were significantly associated (P < .01) with preeclampsia status, and the classification performance of these analytes represented by area under the receiver operating characteristic curve was 0.99, 0.96, 0.94, and 0.98, respectively, with 95% confidence intervals of 0.98–1.00, 0.89–1.00, 0.86–1.00, and 0.94–1.00, respectively. Increased GlyFn levels were significantly associated with gestational age at delivery (P < .01), blood pressure (P = .04), and small-for-gestational-age neonates. Repeated-measures analysis of the difference in weekly GlyFn change in the third trimester demonstrated that mild preeclampsia was associated with a weekly change of 81.7 μg/mL (SE 94.1) vs 195.2 μg/mL (SE 88.2) for severe preeclampsia. The GlyFn POC demonstrated similar performance to a plate assay with an area under the receiver operating characteristic curve of 0.93 and 95% confidence interval of 0.85–1.00.

Conclusion

GlyFn is a robust biomarker for monitoring of preeclampsia in both a standard and POC format, which supports its utility in diverse settings.

Le texte complet de cet article est disponible en PDF.

Key words : biomarker, glycosylated fibronectin, point-of-care, preeclampsia

Plan

Materials and Methods

Strengths and weaknesses

Mechanisms

	This research was funded by DiabetOmics Inc.
	M.J.Q., A.L., E.B., and S.R.N. are employees of, C.T.R. and S.R.N. are shareholders in, and M.G.G. is a consultant for DiabetOmics Inc, which supported this work.
	Cite this article as: Rasanen J, Quinn MJ, Laurie A, et al. Maternal serum glycosylated fibronectin as a point-of-care biomarker for assessment of preeclampsia. Am J Obstet Gynecol 2014;211:x.ex-x.ex.