Second and third trimester serum levels of growth‐differentiation factor‐15 in the prediction of pre‐eclampsia

BACKGROUND: Pre-eclampsia (PE) is a significant contributor to maternal and perinatal adverse outcome, however accurate prediction and early diagnosis of this condition remain a challenge. OBJECTIVES: 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 PE and healthy controls. METHODS: This was a case-control study drawn from a prospective observational study for adverse pregnancy outcomes in women attending for their routine second and third trimester hospital visits. Serum GDF-15 was determined in 300 samples using a commercial GDF-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. Multiple linear regression was applied on logarithmically transformed GDF-15 control values to evaluate the influence of gestational age at blood sampling and maternal characteristics on GDF-15 results. Multiples of the normal median (MoM) GDF-15 values, adjusted for gestational age and maternal characteristics, were compared between the PE group and healthy controls. RESULTS: Values of GDF-15 increased with gestational age. There were no significant differences in GDF-15 values between cases of preterm or term PE and normotensive pregnancies at 19-24 or 35-37 weeks of gestation. At 30-34 weeks, GDF-15 MoM values were significantly increased in cases of preterm PE, but not in those who later developed term PE. Elevated GDF-15 MoM values were significantly associated with a shorter interval between sampling at 30-34 weeks and delivery with PE (P=0.005). CONCLUSION: Serum GDF-15 levels at 19-24 or 35-37 weeks of gestation are not predictive of preterm or term PE. At 30-34 weeks, GDF-15 levels are higher in women who subsequently develop pre-eclampsia; however, this difference is small and GDF-15 is unlikely to be useful in clinical practice when used in isolation. This article is protected by copyright. All rights reserved.