MATERNAL SERUM INHIBIN-A CAN PREDICT PREECLAMPSIA

Objective To compare median levels of maternal serum inhibin A in the second trimester blood samples of women who subsequently develop pre-e clampsia and those who do not. Design Retrospective analysis of 13-18 week samples from a bank of serum stored at -40 degrees C, originally taken for Down's syndrome screening. Setting Antenatal clinics in a te aching hospital. Sample Twenty-eight pregnancies with pre-eclampsia an d 701 controls. Samples were taken, on average, 22 weeks before the di agnosis. Main outcome measure Median inhibin A level. Results The medi an inhibin A level in the cases was 2.01 multiples of the gestation-sp ecific median in the controls, a statistically significant elevation ( P < 0.001). Twenty-three (82%) had levels above the normal median; 19 (68%), 15 (54%), and 11 (39%) exceeded the normal 75th, 90th and 95th centiles, respectively. Conclusions In pre-eclampsia the maternal seru m inhibin A level can be increased months before the onset of symptoms . This provides an opportunity to study the early natural history of t he disease and possibly to conduct treatment trials.