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Reproductive Sciences
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Article

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

Basky Thilaganathan, MD, PhD, FRCOG*, Elizabeth Ralph, MSc, Aris T. Papageorghiou, MD, MRCOG, Karen Melchiorre, MD, and Joanna Sheldon, PhD, FRCPath

* To whom correspondence should be addressed. E-mail: basky{at}pobox.com.


  Abstract

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.

First published on May 12, 2009, doi:10.1177/1933719109336618

Reproductive Sciences 2009;16:788.

A more recent version of this article appeared on August 1, 2009

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