Performance of plasma kisspeptin as a biomarker for miscarriage improves with gestation during the first trimester
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objective
To compare the performance of kisspeptin and beta human chorionic gonadotropin (βhCG), both alone and in combination, as biomarkers for miscarriage throughout the first trimester.
Design
Prospective, nested case-control study.
Setting
Tertiary Centre, Queen Charlotte Hospital, London, United Kingdom.
Patient(s)
Adult women who had miscarriages (n = 95, 173 samples) and women with healthy pregnancies (n = 265, 557 samples).
Intervention(s)
The participants underwent serial ultrasound scans and blood sampling for measurement of plasma kisspeptin and βhCG levels during the first trimester.
Main Outcome Measure(s)
The ability of plasma kisspeptin and βhCG levels to distinguish pregnancies complicated by miscarriage from healthy pregnancies unaffected by miscarriage.
Result(s)
Gestation-adjusted levels of circulating kisspeptin and βhCG were lower in samples from women with miscarriages than in women with healthy pregnancies by 79% and 70%, respectively. The area under the receiver-operating characteristic curve for identifying miscarriage during the first trimester was 0.874 (95% confidence interval [CI] 0.844–0.904) for kisspeptin, 0.859 (95% CI 0.820–0.899) for βhCG, and 0.916 (95% CI 0.886–0.946) for the sum of the two markers. The performance of kisspeptin in identifying miscarriage improved with increasing length of gestation, whereas that of βhCG worsened. A decision matrix incorporating kisspeptin, βhCG, and gestational age had 83% to 87% accuracy for the prediction of miscarriage.
Conclusion(s)
Plasma kisspeptin is a promising biomarker for miscarriage and provides additional value to βhCG alone, especially during later gestational weeks of the first trimester.
To compare the performance of kisspeptin and beta human chorionic gonadotropin (βhCG), both alone and in combination, as biomarkers for miscarriage throughout the first trimester.
Design
Prospective, nested case-control study.
Setting
Tertiary Centre, Queen Charlotte Hospital, London, United Kingdom.
Patient(s)
Adult women who had miscarriages (n = 95, 173 samples) and women with healthy pregnancies (n = 265, 557 samples).
Intervention(s)
The participants underwent serial ultrasound scans and blood sampling for measurement of plasma kisspeptin and βhCG levels during the first trimester.
Main Outcome Measure(s)
The ability of plasma kisspeptin and βhCG levels to distinguish pregnancies complicated by miscarriage from healthy pregnancies unaffected by miscarriage.
Result(s)
Gestation-adjusted levels of circulating kisspeptin and βhCG were lower in samples from women with miscarriages than in women with healthy pregnancies by 79% and 70%, respectively. The area under the receiver-operating characteristic curve for identifying miscarriage during the first trimester was 0.874 (95% confidence interval [CI] 0.844–0.904) for kisspeptin, 0.859 (95% CI 0.820–0.899) for βhCG, and 0.916 (95% CI 0.886–0.946) for the sum of the two markers. The performance of kisspeptin in identifying miscarriage improved with increasing length of gestation, whereas that of βhCG worsened. A decision matrix incorporating kisspeptin, βhCG, and gestational age had 83% to 87% accuracy for the prediction of miscarriage.
Conclusion(s)
Plasma kisspeptin is a promising biomarker for miscarriage and provides additional value to βhCG alone, especially during later gestational weeks of the first trimester.
Date Issued
2021-09-01
Date Acceptance
2021-04-20
Citation
Fertility and Sterility, 2021, 116 (3), pp.809-819
ISSN
0015-0282
Publisher
Elsevier
Start Page
809
End Page
819
Journal / Book Title
Fertility and Sterility
Volume
116
Issue
3
Copyright Statement
© 2021 The Authors. Published by Elsevier Inc. on behalf of the American Society for Reproductive Medicine. This is an open access article underthe CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Sponsor
National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
Genesis Research Trust
Genesis Research Trust
Genesis Research Trust
Identifier
https://www.sciencedirect.com/science/article/pii/S0015028221003058?via%3Dihub
Grant Number
CS-2018-18-ST2-002
RDF01
Award 1086
1086
0118 / GEN 101
Subjects
Kisspeptin
miscarriage
pregnancy
Obstetrics & Reproductive Medicine
1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
1117 Public Health and Health Services
Publication Status
Published
Date Publish Online
2021-05-27