Second and third trimester serum levels of growth differenti
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Pre-eclampsia (PE) is a significant contributor to adverse maternal and perinatal outcomes; however, accurate prediction and early diagnosis of this condition remain a challenge. The aim of this study was to compare serum levels of growth-differentiation factor-15 (GDF-15) at three different gestational ages between asymptomatic women who subsequently developed preterm or term Preeclampsia and healthy controls.

This was a case-control study drawn from a prospective observational study on adverse pregnancy outcomes in women attending for their routine second-and third-trimester hospital visits. Serum growth-differentiation factor-15 was determined in 300 samples using a commercial growth-differentiation factor-15 enzyme-linked immunosorbent assay: 120 samples at 19–24 weeks of gestation, 120 samples at 30–34 weeks, and 60 samples at 35–37 weeks.

Values of growth-differentiation factor-15 increased with gestational age. There were no significant differences in growth-differentiation factor-15 MoM values between cases of preterm or term Pre-eclampsia and normotensive pregnancies at 19–24 or 35–37 weeks of gestation. At 30–34-weeks, growth-differentiation factor-15 MoM values were significantly increased in cases of preterm Preeclampsia, but not in those who later developed term Preeclampsia. Elevated growth-differentiation factor-15 MoM values were associated significantly with a shorter interval between sampling at 30–34 weeks and delivery with Preeclampsia.

Serum growth-differentiation factor-15 levels at 19-24 or 35–37weeks of gestation are not predictive of preterm or term Preeclampsia. At 30–34 weeks, growth-differentiation factor-15 levels are higher in women who subsequently develop preterm Preeclampsia; however, this difference is small and growth-differentiation factor-15 is unlikely to be useful in clinical practice when used in isolation.