Frontiers in endocrinology · 2025
Decreased plasma APOA1 levels are associated with increased severity of placenta accreta spectrum disorders: a nested case-control study.
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Zeng Shuai, Qu Jiangxue, Jiang Hai, Shi Huifeng, Yan Jie, Zhao Yangyu, Chen Lian
Аннотация
OBJECTIVE: Placenta accreta spectrum (PAS) disorders are a series of gestational diseases, with severe adverse outcomes. Apolipoprotein A1 (APOA1) is a lipid molecule that plays a role in cell invasion, inflammation and immune response. This study aimed to elucidate the relationship between APOA1 and PAS, as well as its adverse outcomes.
METHODS: This is a nested case-control study involving 118 patients with PAS and 118 non-PAS control women. Plasma APOA1 levels were evaluated at gestational weeks 24+0 to 35+6 by enzyme-linked immunosorbent assay. The clinical characteristics and pregnancy outcomes were recorded and analyzed in relation to APOA1 levels.
RESULTS: The plasma APOA1 level in the PAS group was observed to be lower than that in the non-PAS group (p = 0.035). From 24+0 to 35+6 weeks of gestation, the trajectory of plasma APOA1 levels in the placenta percreta (PP) and placenta increta group exhibited a discernible decline. Maternal plasma APOA1 is a significant biomarker for the diagnosis of PAS and its adverse outcomes, particularly in the 32+0 to 35+6 weeks of gestation range for invasive PAS (AUC = 0.761, 95% CI 0.660-0.863, p < 0.001), PP (AUC = 0.889, 95% CI 0.801-0.976, p < 0.001), blood transfusion (AUC = 0.729, 95% CI 0.620-0.838, p < 0.001) and hysterectomy (AUC = 0.884, 95% CI 0.790-0.978, p < 0.001).
CONCLUSIONS: A reduction in maternal plasma APOA1 levels was associated with the severity of PAS. APOA1 may serve as a biomarker for invasive PAS, blood transfusion and hysterectomy in late gestation.
METHODS: This is a nested case-control study involving 118 patients with PAS and 118 non-PAS control women. Plasma APOA1 levels were evaluated at gestational weeks 24+0 to 35+6 by enzyme-linked immunosorbent assay. The clinical characteristics and pregnancy outcomes were recorded and analyzed in relation to APOA1 levels.
RESULTS: The plasma APOA1 level in the PAS group was observed to be lower than that in the non-PAS group (p = 0.035). From 24+0 to 35+6 weeks of gestation, the trajectory of plasma APOA1 levels in the placenta percreta (PP) and placenta increta group exhibited a discernible decline. Maternal plasma APOA1 is a significant biomarker for the diagnosis of PAS and its adverse outcomes, particularly in the 32+0 to 35+6 weeks of gestation range for invasive PAS (AUC = 0.761, 95% CI 0.660-0.863, p < 0.001), PP (AUC = 0.889, 95% CI 0.801-0.976, p < 0.001), blood transfusion (AUC = 0.729, 95% CI 0.620-0.838, p < 0.001) and hysterectomy (AUC = 0.884, 95% CI 0.790-0.978, p < 0.001).
CONCLUSIONS: A reduction in maternal plasma APOA1 levels was associated with the severity of PAS. APOA1 may serve as a biomarker for invasive PAS, blood transfusion and hysterectomy in late gestation.