Reduced levels of plasma kisspeptin during the antenatal booking visit are associated with increased risk of miscarriage
CN Jayasena, A Abbara… - The Journal of …, 2014 - academic.oup.com
CN Jayasena, A Abbara, C Izzi-Engbeaya, AN Comninos, RA Harvey, J Gonzalez Maffe…
The Journal of Clinical Endocrinology & Metabolism, 2014•academic.oup.comContext: Kisspeptin is a recently identified hormone encoded by the KISS1 gene, playing a
critical role in human reproduction. Plasma kisspeptin levels rise dramatically during normal
pregnancy due to placental synthesis, which implicates it as a potential tool for assessing
risks of pregnancy complications. No previous prospective study has investigated the
association between plasma kisspeptin and risk of miscarriage. Objective: The objective of
the study was to determine whether a single plasma kisspeptin or serum human chorionic …
critical role in human reproduction. Plasma kisspeptin levels rise dramatically during normal
pregnancy due to placental synthesis, which implicates it as a potential tool for assessing
risks of pregnancy complications. No previous prospective study has investigated the
association between plasma kisspeptin and risk of miscarriage. Objective: The objective of
the study was to determine whether a single plasma kisspeptin or serum human chorionic …
Context
Kisspeptin is a recently identified hormone encoded by the KISS1 gene, playing a critical role in human reproduction. Plasma kisspeptin levels rise dramatically during normal pregnancy due to placental synthesis, which implicates it as a potential tool for assessing risks of pregnancy complications. No previous prospective study has investigated the association between plasma kisspeptin and risk of miscarriage.
Objective
The objective of the study was to determine whether a single plasma kisspeptin or serum human chorionic gonadotropin (hCG) measurement in asymptomatic women attending their booking antenatal visit is associated with miscarriage.
Design
This was a prospective cohort study.
Setting
The study was conducted at a tertiary obstetric center.
Participants
A total of 993 asymptomatic pregnant women with a gestation of 6 weeks or longer attending routine antenatal booking visit were recruited between January 2010 and December 2012.
Main Outcome Measures
Plasma kisspeptin and serum hCG were measured during the antenatal booking visit. Pregnancy outcome was recorded prospectively.
Results
Plasma kisspeptin correlated with gestation (r2 = 0.57; P < .0001). Gestational age-corrected (multiples of median) plasma kisspeptin was 60.4% lower (P < .001), and multiples of median-hCG was 36.1% lower (P < .001) in women later diagnosed with miscarriage compared with women without miscarriage. Increased plasma kisspeptin was associated with reduced miscarriage risk, even after adjusting for age, body mass index, gestational age, smoking, and blood pressure [odds ratio 0.13 (95% confidence interval 0.08–0.22), P = .0001]. Kisspeptin had a higher diagnostic performance for miscarriage than hCG (receiver-operator characteristic-area under the curve 0.899 ± 0.025 plasma kisspeptin; 0.775 ± 0.040, serum hCG, P < .01 vs plasma kisspeptin).
Conclusion
Our data suggest for the first time that a single plasma kisspeptin measurement taken during the antenatal booking visit provides a potential novel marker for identifying asymptomatic pregnant women at a gestation of 6 weeks or greater at increased risk of miscarriage.
Oxford University Press