1 Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet2 Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet3 unknown4 Undervisning - SB, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet5 Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet6 Undervisning - SB, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet
OBJECTIVE: To test if serum YKL-40 is increased in women developing preeclampsia or small-for-gestational age fetuses. We also assessed the association between uterine artery pulsatility index, notching and serum YKL-40 levels. DESIGN: Prospective cohort study. SETTING: A primary referral unit for obstetric ultrasound. POPULATION: A total of 1214 unselected pregnant women enrolled at nuchal translucency examination between 11(+3) and 13(+6) weeks of gestation. METHODS: All women had ultrasound and blood sample collection at the nuchal translucency scan, a 20-week malformation scan and 25-week and 32-week fetal growth examinations. Uterine artery Doppler was assessed and outcome was registered from medical records. MAIN OUTCOME MEASURES: Preeclampsia, hypertension, small-for-gestational age. RESULTS: Serum YKL-40 was associated with increasing maternal age (p < 0.0001), body mass index (p = 0.0002), primiparity (p = 0.0003), and hypertension (p = 0.015). Serum YKL-40 increased from 12 to 20 weeks and decreased from 20-25 and 25-32 weeks of gestation. No association was found between preeclampsia and serum YKL-40. Small-for-gestational-age at birth was significantly associated with a 5.4% increase in serum YKL-40 at 32 weeks of gestation (95% CI 1.5-9.3, p = 0.005). An association was found between uterine artery pulsatility index at 32 weeks and small-for-gestational age (p = 0.0015) but not between YKL-40 and uterine artery notching (p = 0.83). CONCLUSIONS: Serum YKL-40 was not associated with preeclampsia. Increasing serum YKL-40 was related to maternal age, body mass index and small-for-gestational age and may reflect an exaggerated inflammatory response.
Acta Obstetricia Et Gynecologica Scandinavica, 2014, Vol 93, Issue 8, p. 817-24
Adipokines; Adolescent; Adult; Biological Markers; Enzyme-Linked Immunosorbent Assay; Female; Fetal Growth Retardation; Humans; Infant, Newborn; Infant, Small for Gestational Age; Lectins; Linear Models; Logistic Models; Pre-Eclampsia; Pregnancy; Prospective Studies; Pulsatile Flow; Ultrasonography, Doppler, Color; Ultrasonography, Prenatal; Uterine Artery; Young Adult