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Concentrations of Serum Total Activin A and Inhibin A in Preterm and Term Labor Patients: A Cross-Sectional Study

Women and Infants' Hospital of Rhode Island, 101 Dudley Street, Providence RI 02905; mplevyak{at}wihri.org

Garalyn M. Lambert-Messerlian, PhD

Antonio Farina, MD

Nigel P. Groome, PhD

Jacob A. Canick, PhD

Helayne M. Silver, MD

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gyne-cology, Brown University, Department of Pathology and Laboratory Medicine, Brown University, providence, Rhode Island; Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy; and School of Biological and Molecular Sciences, Oxford Brookes University, Oxford, United Kingdom

Objective: To compare maternal serum levels of total activin A and inhibin A in preterm and tem patients who are in labor or not in laboar.

Methods: A cross-sectional study compared activin A and inhibin A in the following groups of patients: preterm and in labour (n = 65), preterm and not in labor (n = 96), term and in labor (n = 65), and term and not in labor (n = 65). Preterm was defined as 23-34 weeks' gestation and term as 37-43 weeks' gestation. Lobor was defined as regular contractions with progressive cervical change or an initial examination revealing cervical dilation of 1-3 cm with 50% effacement or more. Follistatin levbels were analyzed in a subset of 12 patients from each group. Analytes were measured by two-site enzyme-linked immunosorbent assays.

Results: Activin A levels were higher in the preterm labor group (median 1.38 multiples of the median [MoM], interquartile range [IQR] 1.01 MoM) compared with the preterm nonlabor group (median 1.0 MoM, IQR 0.78 MoM, P < .05) and in the term labor group (median 1.37 MoM, IQR 1.74 MoM) compared with the term nonlabor group (median 1.0 MoM, IQR 0.87 MoM, P < .05). Inhibin A levels were higher in the preterm labor group (median 1.27 MoM, IQR 0.73 MoM) compared with the preterm nonlabaor group (median 1.0 MoM, IQR 0.58 MoM, P < .05). Post-hoc analysis of activin A andinhibin A elevations in the preterm labor group revealed a significant effect only during 31-34 weeks' gestation. The total activin A:follistatin ratio, an indirect measure of free activin A, was similar between labor and nonlabor gestational age-matched patient groups.

Conclusions: Levels of total activin A and inhibin A were increased in patients during labor; however, based on the moderate degree and narror gestational age range of the increased levels, these analytes are not likely to be clinically useful in predicting preterm labor.

Key Words: Activin A • follistatin • inhibin A • labor • preterm labor

Journal of the Society for Gynecologic Investigation, Vol. 10, No. 4, 231-236 (2003)
DOI: 10.1016/S1071-55760300047-9


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