First-trimester maternal serum PP13 in the risk assessment for preeclampsia

Roberto Romero, Juan Pedro Kusanovic, Nandor Gabor Than, Offer Erez, Francesca Gotsch, Jimmy Espinoza, Samuel Edwin, Ilana Chefetz, Ricardo Gomez, Jyh Kae Nien, Marei Sammar, Beth Pineles, Sonia S. Hassan, Hamutal Meiri, Yossi Tal, Ido Kuhnreich, Zoltan Papp, Howard S. Cuckle

Research output: Contribution to journalArticlepeer-review

133 Scopus citations


Objective: The objective of the study was to determine whether first-trimester maternal serum placental protein 13 (PP13) concentrations can be used in the risk assessment for preeclampsia. Study Design: This case-control study included 50 patients with preeclampsia and 250 patients with normal pregnancies. Samples were collected between 8 and 13 weeks of gestation. Serum PP13 concentrations were measured by immunoassay and expressed as medians and multiples of the median (MoM) for gestational age. Sensitivity and specificity were derived from receiver-operating characteristic curve analysis. Results: (1) Serum PP13 concentration in the first trimester was significantly lower in patients who developed preterm and early-onset preeclampsia than in those with normal pregnancies; and (2) at 80% specificity, a cutoff of 0.39 MoM had a sensitivity of 100% for early-onset preeclampsia and 85% for preterm preeclampsia. Conclusion: Maternal serum first-trimester PP13 appears to be a reasonable marker for risk assessment for preterm preeclampsia but a weak marker for severe preeclampsia at term, and ineffective for identifying mild preeclampsia at term.

Original languageEnglish (US)
Pages (from-to)122.e1-122.e11
JournalAmerican journal of obstetrics and gynecology
Issue number2
StatePublished - Aug 2008
Externally publishedYes

Bibliographical note

Funding Information:
This research was supported, in part, by the Intramural Research Program of the National Institute of Child Health and Human Development, Eunice Kennedy Shriver National Institutes of Health, Department of Health and Human Services, and Grants 31851 and 42872 from Israel Chief Scientist (to H.M.).


  • high-risk pregnancy
  • maternal serum biochemistry
  • prenatal care
  • risk assessment
  • screening


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