Dataset Information

Kisspeptin as a new serum biomarker to discriminate miscarriage from viable intrauterine pregnancy.

ABSTRACT: OBJECTIVE:To validate the ability of serum kisspeptin-54 to discriminate between first-trimester viable pregnancies and miscarriages. DESIGN:Case-control study. SETTING:Academic medical centers. PATIENT(S):Women with confirmed viable intrauterine pregnancy (IUP) at estimated gestational age 6-10 weeks (n = 20), women with confirmed miscarriage (spontaneous abortion [SAB]) at estimated gestational age 6-10 weeks (n = 20), and nonpregnant women (n = 19). INTERVENTION(S):Collection of serum samples from women with confirmed IUP, SAB, and nonpregnant women for the measurement of serum kisspeptin and serum hCG levels. MAIN OUTCOME MEASURE(S):Serum kisspeptin and hCG. RESULT(S):The limit of detection was 0.024 ng/mL; intra- and interassay coefficients of variation were 5.1% and 8.6%, respectively. Kisspeptin levels differed between the pregnant and nonpregnant state and by viability. Kisspeptin levels were positively associated with gestational age. There was also a significant positive association with hCG in SAB, but not in IUP. CONCLUSION(S):Plasma levels of kisspeptin have been suggested as a biomarker for miscarriage. This study demonstrates kisspeptin assay stability in serum and its potential clinical utility as a biomarker for early pregnancy viability.

SUBMITTER: Sullivan-Pyke C

PROVIDER: S-EPMC5771501 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Kisspeptin as a new serum biomarker to discriminate miscarriage from viable intrauterine pregnancy.

Sullivan-Pyke Chantae C Haisenleder Daniel J DJ Senapati Suneeta S Nicolais Olivia O Eisenberg Esther E Sammel Mary D MD Barnhart Kurt T KT

Fertility and sterility 20180101 1

<h4>Objective</h4>To validate the ability of serum kisspeptin-54 to discriminate between first-trimester viable pregnancies and miscarriages.<h4>Design</h4>Case-control study.<h4>Setting</h4>Academic medical centers.<h4>Patient(s)</h4>Women with confirmed viable intrauterine pregnancy (IUP) at estimated gestational age 6-10 weeks (n = 20), women with confirmed miscarriage (spontaneous abortion [SAB]) at estimated gestational age 6-10 weeks (n = 20), and nonpregnant women (n = 19).<h4>Interventio ...[more]

PMID: 29307393

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Project description:ObjectiveTo identify factors associated with contraceptive uptake among participants in a miscarriage management clinical trial.Study designWe performed a secondary analysis of a multi-center, randomized controlled trial of medical management regimens for miscarriage between 5 and 12 completed weeks. Pregnancy intention was measured by patient report after miscarriage diagnosis. Participants were offered contraception in accordance with standard clinical care once their miscarriage was completed. We analyzed participants as a cohort and fit a multivariable model to describe demographic characteristics and pregnancy intentions independently associated with contraceptive uptake.ResultsOf 244 participants with available contraceptive outcomes, 121 (50%) stated that this pregnancy was planned, and 218 (90%) stated that they had planned to continue the pregnancy to term. Ninety-seven participants (40%) initiated contraception: 33 (14%) selected a long-acting reversible method, 44 (18%) a short-acting reversible method, and 20 (8%) condoms or emergency contraception, while 147 (60%) declined contraception after miscarriage completion. In the multivariable model, unplanned pregnancy (aRR 2.13, 95% CI: 1.45-3.13) and lack of intention to continue the pregnancy (aRR 1.61, 95% CI: 1.18-2.20) were independently associated with contraceptive uptake. Of participants who declined contraception, 85 (57%) did so in order to conceive again. Nearly one-quarter of participants who declined contraception described the index pregnancy as unplanned, but after miscarriage planned to conceive a new pregnancy.ConclusionPatients with unplanned pregnancy who miscarried were twice as likely to initiate contraception as those with planned pregnancy, however pregnancy intentions sometimes changed after miscarriage.ImplicationsMiscarriage management represents an important opportunity to clarify pregnancy goals and provide contraceptive counseling. Although unplanned pregnancy correlates with contraceptive uptake, we do not recommend using this clinically to predict contraceptive need. Future research should examine how best to measure pregnancy intention and its relationship to the experience of miscarriage.

Project description:BackgroundTuberculosis remains a major public health problem worldwide accounting for 1.4 million deaths annually. LL-37 is an effector molecule involved in immunity with both antimicrobial and immunomodulatory properties. The purpose of this study was to compare LL-37 circulatory levels among participants with active and latent tuberculosis and to determine its ability to discriminate between the two infectious states.MethodsA cross-sectional study was performed among 56 active tuberculosis patients, 49 latent tuberculosis individuals, and 43 individuals without tuberculosis infection. The enzyme-linked immunosorbent assay was used to assess LL-37 levels. Data analysis was performed using STATA software and Graph pad Prism version 8. Mann-Whitney U test was used for correlation between variables with two categories and the Kruskal-Wallis test for three or more categories.ResultsThe study had more female participants than males, with similar median ages across the three groups, 29.5, 25.0, and 23.0 years respectively. Active tuberculosis patients had significantly higher LL-37 levels compared to those with latent tuberculosis and without tuberculosis. The median/interquartile ranges were 318.8 ng/ml (157.9-547.1), 242.2 ng/ml (136.2-579.3), 170.9 ng/ml (129.3-228.3); p = 0.002 respectively. Higher LL-37 was found in the male participant with median/interquartile range, 424.8 ng/ml (226.2-666.8) compared to the females 237.7 ng/ml (129.6-466.6); p = 0.045. LL-37 had better discriminatory potential between active tuberculosis and no tuberculosis (AUC = 0.71, sensitivity 71.4% specificity = 69.8%) than with latent tuberculosis (AUC = 0.55, sensitivity = 71.4%, specificity = 44.9%). There was moderate differentiation between latent tuberculosis and no tuberculosis (AUC = 0.63, sensitivity = 44.9% specificity = 90.7%).ConclusionSignificantly higher LL-37 levels were observed among active tuberculosis patients than those without tuberculosis infection and were, therefore able to discriminate between active tuberculosis and other tuberculosis infectious states, especially with no tuberculosis. Further assessment of this biomarker as a screening tool to exclude tuberculosis is required.

Dataset Information

Kisspeptin as a new serum biomarker to discriminate miscarriage from viable intrauterine pregnancy.

Publications

Kisspeptin as a new serum biomarker to discriminate miscarriage from viable intrauterine pregnancy.

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