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Journal of the Society for Gynecologic Investigation
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Mechanism of Increased Maternal Serum Total Activin A and Inhibin A in Preeclampsia

Helayne M. Silver, MD

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, and Department of Pathology, Brown University, Providence, Rhode Island; Department of Obstetrics and Gynecology University of Udine, Udine, Italy; Molecular Biology Laboratory, Istituto Auxologico Italiano, Milan, Italy; Women and Infants' Hospital of Rhode Island, 101 Dudley Street, Providence, RI 02905 hsilver{at}wihri.org

Garalyn M. Lambert-Messerlian, PhD

Fernando M. Reis, MD, PhD

Anna Maria Diblasio, MD

Felice Petraglia, MD

Jacob A. Canick, PhD

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, and Department of Pathology, Brown University, Providence, Rhode Island; Department of Obstetrics and Gynecology University of Udine, Udine, Italy; Molecular Biology Laboratory, Istituto Auxologico Italiano, Milan, Italy

Objective: To determine whether increased levels of maternal serum total activin A and inhibin A in preeclampsia are related to total blood volume, urinary clearance, or placental production.

Study Design: Activin A and inhibin A levels were measured in preeclamptic subjects and matched normotensive gravidas. In a subset of preeclamptic subjects (n = 21) and controls (n = 30), we performed blood volume studies. In an overlapping subject of preeclamptic subjects (n = 56), creatinine clearance results were available. Placental tissue was obtained from six preeclamptics and matched normotensive gravida for analysis of activin A and inhibin A mRNA expression.

Results: Maternal serum levels of inhibin A but not activin A were significantly negatively correlated with blood volume in preeclampsia (r2 = .26, P = 0.17, and r2 = .02, P = .44, respectively). Levels of both proteins were negatively correlated to creatinine clearance (r2 = .29, P < .0001, and r2 = .15, P = .003, respectively). Placental mRNA expression for both the {alpha} and ßA subunits was increased in preeclampsia (P = .038 and .049, respectively).

Conclusion: Although placental mRNA expression of the subunits for both analytes is increased in preeclampsia, the increased levels of activin A appear to be more specifically a reflection of increased placental production than do the increased levels of inhibin A.

Key Words: Inhibin A • activin A • preeclampsia • gestational hypertension

Journal of the Society for Gynecologic Investigation, Vol. 9, No. 5, 308-312 (2002)
DOI: 10.1177/107155760200900509
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