Serum inhibin A and activin A are elevated prior to the onset of pre-eclampsia

Serum inhibin A and activin A concentrations increase in pre-eclampsia, We investigated the time courses of the changes in relation to the onset of th e maternal syndrome and if their measurement could be useful for clinical p rediction particularly in relation to early onset disease, the most severe of the clinical presentations, Serial samples were taken from 1496 healthy nulliparae, Changes in activin A and inhibin A were analysed in women with: early onset pre-eclampsia (n = 11), pre-eclampsia delivering at 34-36 week s (n = 14), term pre-eclampsia (n = 25) and gestational hypertension (n = 2 5); and in a subset with uncomplicated pregnancies (n = 25), Serum inhibin A and activin A were increased in all groups prior to preeclampsia, before 20 weeks in those with early onset pre-eclampsia, Screening efficacy was de termined at 15-19 and 21-25 weeks in all women who developed pre-eclampsia (n = 70) and randomly selected controls (n = 240), Predictive sensitivities were low (16-59%) but much better for early onset pre-eclampsia: 67 and 44 % at 15-19 weeks and 89 and 89% at 21-25 weeks for inhibin A and activin A respectively. Hence, serum inhibin A and activin A concentrations increase before the onset of pre-eclampsia at gestational ages that depend on when p re-eclampsia develops. On their own such measures are unlikely to prove eff icient for screening.