Is Afamin a Potential Early Biomarker for Subsequent Development of Preeclampsia? A Nested Case-Control Study

Abstract

Objective The objective of this study is to determine if the second-trimester serum afamin is a reasonable predictor of preeclampsia (PE). Methods In this nested case-control study, all pregnant women were screened by second-trimester screening test between 15 and 20 weeks of gestation and serum samples were collected and stored at -80 degrees C for biochemical analysis. All available stored samples from pregnant women who subsequently developed PE were thawed and the concentrations of afamin in the serum were measured. Control cases, chosen randomly from the same cohort whose blood was collected and stored in the same period as with the study group, who did not develop PE. Afamin levels were expressed ng/mL. Logistic regression was used to calculate adjusted odds ratio (aORs) for the prediction of PE. Results A total of 39 women with PE and 46 controls were studied. Afamin levels were found to be significantly higher during the second trimester in women who developed PE compared to the control group. Afamin, at a cut-off level of 96.2 ng/mL, the aORs for PE was 28.6 (95% CI: 7.458-110.193). After adjustment for BMI, age, smoking, the aORs for PE was 65.6 (95% CI: 11.6-371.4;p= .001). Conclusion High levels of afamin in the early weeks of gestation in patients going on to develop PE later may be promising as a potential marker to predict PE in the first and second trimesters.