Quantifying mRNA coding growth genes in the maternal circulation to detect fetal growth restriction - 25/07/13
Abstract |
Objective |
To examine whether mRNA circulating in maternal blood coding genes regulating fetal growth are differentially expressed in (1) severe preterm fetal growth restriction (FGR) and (2) at 28 weeks' gestation in pregnancies destined to develop FGR at term.
Study Design |
mRNA coding growth genes were measured in 2 independent cohorts. The first was women diagnosed with severe preterm FGR (<34 weeks' gestation; n = 20) and gestation matched controls (n = 15), where the mRNA was measured in both maternal blood and placenta. The second cohort was a prospective longitudinal study (n = 52) of women whom had serial ultrasound assessments of fetal growth. mRNA coding growth genes in maternal blood were measured at 28 and 36 weeks in pregnancies with declining growth trajectories (ending up with term FGR; n = 10 among the 52 recruited) and controls who maintained normal growth trajectory (n = 15).
Results |
In women with severe preterm FGR, there was increased expression of placental growth hormone (6.3-fold), insulin-like growth factors (IGF1, 3.4-fold; IGF2, 5.0-fold), IGF receptors (2.1-fold) and IGF binding proteins (3.0-fold), and reduced expression of ADAM12 (0.5-fold) in maternal blood (and similar trends in placenta) compared with controls (P < .05). Notably, at 28 weeks' gestation there was increased IGF2 (3.9-fold), placental growth hormone (2.7-fold), and IGF BP2 (2.1-fold) expression in maternal blood in women destined to develop FGR at term (P < .05).
Conclusion |
Measuring mRNA coding growth genes in maternal blood may detect unsuspected severe preterm FGR already present in utero, and predict term FGR when measured at 28 weeks' gestation.
Le texte complet de cet article est disponible en PDF.Key words : biomarker, fetal growth restriction, free RNA, maternal circulation, placenta
Plan
| M.L. and S.T. are supported by NHMRC Career Development Fellowships. C.W is supported by a Royal Australian and New Zealand College of Obstetricians and Gynaecologists Arthur Wilson Scholarship, a William Buckland Foundation Grant, and a Medical Research Foundation for Women and Babies grant. S.T. and S.W are supported by NHMRC Project grant number 1028521. |
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| The authors report no conflicts of interest. |
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| Reprints not available from authors. |
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| Cite this article as: Whitehead CL, Walker SP, Mendis S, et al. Quantifying mRNA coding growth genes in the maternal circulation to detect fetal growth restriction. Am J Obstet Gynecol 2013;209:133.e1-9. |
Vol 209 - N° 2
P. 133.e1-133.e9 - août 2013 Retour au numéro
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