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Reduced Levels of Plasma Kisspeptin During the Antenatal Booking Visit Are Associated With Increased Risk of Miscarriage

Jayasena, C. N ; Abbara, A ; Izzi-Engbeaya, C ; Comninos, A. N ; Harvey, R. A ; Gonzalez Maffe, J ; Sarang, Z ; Ganiyu-Dada, Z ; Padilha, A. I ; Dhanjal, M ; Williamson, C ; Regan, L ; Ghatei, M. A ; Bloom, S. R ; Dhillo, W. S

The journal of clinical endocrinology and metabolism, 2014-12, Vol.99 (12), p.E2652-E2660 [Periódico revisado por pares]

United States: Endocrine Society

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  • Título:
    Reduced Levels of Plasma Kisspeptin During the Antenatal Booking Visit Are Associated With Increased Risk of Miscarriage
  • Autor: Jayasena, C. N ; Abbara, A ; Izzi-Engbeaya, C ; Comninos, A. N ; Harvey, R. A ; Gonzalez Maffe, J ; Sarang, Z ; Ganiyu-Dada, Z ; Padilha, A. I ; Dhanjal, M ; Williamson, C ; Regan, L ; Ghatei, M. A ; Bloom, S. R ; Dhillo, W. S
  • Assuntos: Abortion, Spontaneous - blood ; Abortion, Spontaneous - epidemiology ; Adult ; Chorionic Gonadotropin - blood ; Cohort Studies ; Female ; Gestational Age ; Hot Topics in Translational Endocrinology ; Humans ; Kisspeptins - blood ; Pregnancy ; Pregnancy Trimester, First ; Prenatal Care ; Prospective Studies ; Risk
  • É parte de: The journal of clinical endocrinology and metabolism, 2014-12, Vol.99 (12), p.E2652-E2660
  • Notas: C.N.J. is supported by a National Institute for Health Research (NIHR) Clinical Lectureship and Academy of Medical Science Starter Grant; A.A. is supported by a Wellcome Clinical Research Training Fellowship; C.I.-E. is supported by an NIHR Academic Clinical Fellowship; A.N.C. is supported by a Wellcome/GSK Clinical Research Fellowship; and W.S.D. is supported by an NIHR Career Development Fellowship. The Department of Investigative Medicine (Imperial College London) is supported by the NIHR Imperial Biomedical Research Centre.
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    C.N.J. and A.A. contributed equally to this work.
  • Descrição: Context: Kisspeptin is a recently identified hormone encoded by the KISS1 gene, playing a critical role in human reproduction. Plasma kisspeptin levels rise dramatically during normal pregnancy due to placental synthesis, which implicates it as a potential tool for assessing risks of pregnancy complications. No previous prospective study has investigated the association between plasma kisspeptin and risk of miscarriage. Objective: The objective of the study was to determine whether a single plasma kisspeptin or serum human chorionic gonadotropin (hCG) measurement in asymptomatic women attending their booking antenatal visit is associated with miscarriage. Design: This was a prospective cohort study. Setting: The study was conducted at a tertiary obstetric center. Participants: A total of 993 asymptomatic pregnant women with a gestation of 6 weeks or longer attending routine antenatal booking visit were recruited between January 2010 and December 2012. Main Outcome Measures: Plasma kisspeptin and serum hCG were measured during the antenatal booking visit. Pregnancy outcome was recorded prospectively. Results: Plasma kisspeptin correlated with gestation (r2 = 0.57; P < .0001). Gestational age-corrected (multiples of median) plasma kisspeptin was 60.4% lower (P < .001), and multiples of median-hCG was 36.1% lower (P < .001) in women later diagnosed with miscarriage compared with women without miscarriage. Increased plasma kisspeptin was associated with reduced miscarriage risk, even after adjusting for age, body mass index, gestational age, smoking, and blood pressure [odds ratio 0.13 (95% confidence interval 0.08–0.22), P = .0001]. Kisspeptin had a higher diagnostic performance for miscarriage than hCG (receiver-operator characteristic-area under the curve 0.899 ± 0.025 plasma kisspeptin; 0.775 ± 0.040, serum hCG, P < .01 vs plasma kisspeptin). Conclusion: Our data suggest for the first time that a single plasma kisspeptin measurement taken during the antenatal booking visit provides a potential novel marker for identifying asymptomatic pregnant women at a gestation of 6 weeks or greater at increased risk of miscarriage.
  • Editor: United States: Endocrine Society
  • Idioma: Inglês
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