Serum Macrophage Stimulating Protein α-chain and Uterine Artery Doppler Ultrasound in the First Trimester for the Prediction of Preeclampsia

Overview

Journal Sci Rep

Specialty Science

Date 2024 Sep 19

PMID 39300215

Authors

Pimon Kongprayoon

Vorapong Phupong

Affiliations

Soon will be listed here.

Abstract

To assess how effective macrophage stimulating protein α-chain (MSP-α) combined with uterine artery Doppler is in predicting preeclampsia in singleton pregnancies during 11-13 weeks of gestation. This prospective observational study included singleton pregnant women who attended antenatal care at King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University between December 2021 and April 2023, during 11-13 weeks of gestation. Serum MSP-α levels were collected and uterine artery Doppler ultrasound was performed. Pregnancy outcomes were recorded, and the predictive values of these tests were determined to predict preeclampsia. A total of 365 patients, with 21 cases of preeclampsia (5.8%), were analyzed. Serum MSP-α levels were higher in pregnant women who developed preeclampsia than those who did not (899.7 ± 550.1 ng/ml vs 642.5 ± 466.1 ng/ml, p = 0.016). The mean pulsatility index of the uterine artery and the presence of diastolic notching were not significantly different between the groups. As a cut-off value for predicting preeclampsia, using serum MSP-α levels higher than 1.0 multiple of median for gestational age, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 71.4%, 50.3%, 8.1%, and 96.7%, respectively. Additionally, when abnormal serum MSP-α levels were combined with a uterine artery Doppler pulsatility index above the 95th percentile and bilateral notching as predictive values for preeclampsia, the sensitivity was 85.7%, specificity was 18.3%, PPV was 6.0%, and NPV was 95.5%. Serum MSP-α alone at 11-13 weeks of gestation was effective in predicting preeclampsia. However, the use of serum MSP-α in combination with uterine artery Doppler increased sensitivity but reduced specificity for the prediction of preeclampsia.

References

Prakansamut N, Phupong V . Serum SHARP1 and uterine artery Doppler for the prediction of preeclampsia. Sci Rep. 2019; 9(1):12266. PMC: 6706446. DOI: 10.1038/s41598-019-48727-8. View

Aksornphusitaphong A, Phupong V . Risk factors of early and late onset pre-eclampsia. J Obstet Gynaecol Res. 2012; 39(3):627-31. DOI: 10.1111/j.1447-0756.2012.02010.x. View

Poon L, Rolnik D, Tan M, Delgado J, Tsokaki T, Akolekar R . ASPRE trial: incidence of preterm pre-eclampsia in patients fulfilling ACOG and NICE criteria according to risk by FMF algorithm. Ultrasound Obstet Gynecol. 2018; 51(6):738-742. DOI: 10.1002/uog.19019. View

Leonard E . Biological aspects of macrophage-stimulating protein (MSP) and its receptor. Ciba Found Symp. 1997; 212:183-91; discussion 192-7. View

Paiboonborirak C, Phupong V . Serum fatty acid binding protein 4 and Doppler of uterine artery ultrasound in the first trimester for the prediction of preeclampsia. Hypertens Res. 2024; 47(5):1208-1215. DOI: 10.1038/s41440-023-01553-y. View

Poon L, Shennan A, Hyett J, Kapur A, Hadar E, Divakar H . The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019; 145 Suppl 1:1-33. PMC: 6944283. DOI: 10.1002/ijgo.12802. View

Cnossen J, Morris R, Ter Riet G, Mol B, van der Post J, Coomarasamy A . Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ. 2008; 178(6):701-11. PMC: 2263112. DOI: 10.1503/cmaj.070430. View

Danilkovitch-Miagkova A, Leonard E . Anti-apoptotic action of macrophage stimulating protein (MSP). Apoptosis. 2001; 6(3):183-90. DOI: 10.1023/a:1011384609811. View

Chappell L, Cluver C, Kingdom J, Tong S . Pre-eclampsia. Lancet. 2021; 398(10297):341-354. DOI: 10.1016/S0140-6736(20)32335-7. View

10.

Brown M, Magee L, Kenny L, Karumanchi S, McCarthy F, Saito S . Hypertensive Disorders of Pregnancy: ISSHP Classification, Diagnosis, and Management Recommendations for International Practice. Hypertension. 2018; 72(1):24-43. DOI: 10.1161/HYPERTENSIONAHA.117.10803. View

11.

. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222. Obstet Gynecol. 2020; 135(6):1492-1495. DOI: 10.1097/AOG.0000000000003892. View

12.

Tianthong W, Phupong V . Serum hypoxia-inducible factor-1α and uterine artery Doppler ultrasound during the first trimester for prediction of preeclampsia. Sci Rep. 2021; 11(1):6674. PMC: 7988168. DOI: 10.1038/s41598-021-86073-w. View

13.

Siricharoenthai P, Phupong V . The first-trimester serum high-temperature requirement protease A4 and uterine artery Doppler for the prediction of preeclampsia. Sci Rep. 2023; 13(1):8295. PMC: 10202921. DOI: 10.1038/s41598-023-35243-z. View

14.

Liu N, Guo Y, Gong L, Wang B . Advances in biomarker development and potential application for preeclampsia based on pathogenesis. Eur J Obstet Gynecol Reprod Biol X. 2020; 9:100119. PMC: 7575783. DOI: 10.1016/j.eurox.2020.100119. View

15.

Zhang Y, Yang H, Zhang Y, Shi J, Chen R . circCRAMP1L is a novel biomarker of preeclampsia risk and may play a role in preeclampsia pathogenesis via regulation of the MSP/RON axis in trophoblasts. BMC Pregnancy Childbirth. 2020; 20(1):652. PMC: 7590488. DOI: 10.1186/s12884-020-03345-5. View

16.

Onwudiwe N, Yu C, Poon L, Spiliopoulos I, Nicolaides K . Prediction of pre-eclampsia by a combination of maternal history, uterine artery Doppler and mean arterial pressure. Ultrasound Obstet Gynecol. 2008; 32(7):877-83. DOI: 10.1002/uog.6124. View

17.

Zhang Y, Yang H, Long Y, Ma Q, Chen R . Plasma Level of Placenta-Derived Macrophage-Stimulating Protein -Chain in Preeclampsia before 20 Weeks of Pregnancy. PLoS One. 2016; 11(8):e0161626. PMC: 4999075. DOI: 10.1371/journal.pone.0161626. View

18.

Roberts J, Hubel C . The two stage model of preeclampsia: variations on the theme. Placenta. 2008; 30 Suppl A:S32-7. PMC: 2680383. DOI: 10.1016/j.placenta.2008.11.009. View

19.

Say L, Chou D, Gemmill A, Tuncalp O, Moller A, Daniels J . Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014; 2(6):e323-33. DOI: 10.1016/S2214-109X(14)70227-X. View

20.

Mikat B, Gellhaus A, Wagner N, Birdir C, Kimmig R, Koninger A . Early detection of maternal risk for preeclampsia. ISRN Obstet Gynecol. 2012; 2012:172808. PMC: 3407628. DOI: 10.5402/2012/172808. View