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Raised Maternal Serum Cystatin C: An Early Pregnancy Marker for Preeclampsia

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Abstract

The balance between trophoblast cathepsin and decidual cystatin C expression is pivotal in physiological trophoblast development. Defective trophoblast invasion is characteristic of preeclampsia and may involve derangement of the cathepsin/cystatin C balance. We conducted a prospective nested case-control study of healthy women with singleton pregnancies in the first trimester of pregnancy. Maternal serum cystatin C concentrations in those subsequently developing preeclampsia (n = 30) were compared to controls with normal outcome (n = 90). The median cystatin C concentration in early pregnancy was significantly higher (P = .0001) in those who subsequently developed preeclampsia (median 0.65 mg/L) when compared to normal pregnancy (median 0.57 mg/L). Of the 30 women developing preeclampsia, 14 (47%) had cystatin C above the 80th centile (0.67 mg/L) for the controls. Maternal serum cystatin C concentrations in early pregnancy may be of value in identifying women at high risk of developing preeclampsia.

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Authors and Affiliations

  1. Fetal Medicine Unit, Division of Clinical Developmental Sciences and Protein Reference Unit, Division of Basic Medical Sciences, St George’s, University of London, Lanesborough Wing, St Georges, Terrace, SW17 0RE, London, United Kingdom

    Basky Thilaganathan MD, PhD, FRCOG, Elizabeth Ralph MSc, Aris T. Papageorghiou MD, MRCOG, Karen Melchiorre MD & Joanna Sheldon PhD, FRCPath

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  1. Basky Thilaganathan MD, PhD, FRCOG
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  2. Elizabeth Ralph MSc
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  3. Aris T. Papageorghiou MD, MRCOG
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  4. Karen Melchiorre MD
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  5. Joanna Sheldon PhD, FRCPath
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Thilaganathan, B., Ralph, E., Papageorghiou, A.T. et al. Raised Maternal Serum Cystatin C: An Early Pregnancy Marker for Preeclampsia. Reprod. Sci. 16, 788–793 (2009). https://doi.org/10.1177/1933719109336618

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