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Reproductive Sciences
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Raised Maternal Serum Cystatin C: An Early Pregnancy Marker for Preeclampsia

Basky Thilaganathan, MD, PhD, FRCOG

Fetal Medicine Unit, Division of Clinical Developmental Sciences, St George's, University of London, United Kingdom, basky{at}pobox.com

Elizabeth Ralph, MSc

Fetal Medicine Unit, Division of Clinical Developmental Sciences, St George's, University of London, United Kingdom

Aris T. Papageorghiou, MD, MRCOG

Fetal Medicine Unit, Division of Clinical Developmental Sciences, St George's, University of London, United Kingdom

Karen Melchiorre, MD

Fetal Medicine Unit, Division of Clinical Developmental Sciences, St George's, University of London, United Kingdom

Joanna Sheldon, PhD, FRCPath

Protein Reference Unit, Division of Basic Medical Sciences, St George's, University of London, United Kingdom

The balance between trophoblast cathepsin and decidual cystatin C expression is pivotal in physiological trophoblast development. Defective trophoblast invasion is characteristic of preeclampsia and may involve derangement of the cathepsin/cystatin C balance. We conducted a prospective nested case-control study of healthy women with singleton pregnancies in the first trimester of pregnancy. Maternal serum cystatin C concentrations in those subsequently developing preeclampsia (n = 30) were compared to controls with normal outcome (n = 90). The median cystatin C concentration in early pregnancy was significantly higher (P = .0001) in those who subsequently developed preeclampsia (median 0.65 mg/L) when compared to normal pregnancy (median 0.57 mg/L). Of the 30 women developing preeclampsia, 14 (47%) had cystatin C above the 80th centile (0.67 mg/L) for the controls. Maternal serum cystatin C concentrations in early pregnancy may be of value in identifying women at high risk of developing preeclampsia.

Key Words: Preeclampsia • cystatin C • biomarker • first trimester.

This version was published on August 1, 2009

Reproductive Sciences, Vol. 16, No. 8, 788-793 (2009)
DOI: 10.1177/1933719109336618
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