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Serum podocalyxin at 11–13 weeks of gestation in the prediction of small for gestational age neonates

Journal of Perinatology volume 39, pages 784–790 (2019)Cite this article

Subjects

Abstract

Objective

To investigate a potential new marker for the prediction of small for gestational age (SGA) infants.

Study design

Nested case-control study involving 280 uncomplicated pregnancies and 70 cases of SGA without pre-eclampsia. Serum podocalyxin was measured at 11–13 weeks of gestation and results were expressed in multiples of the median (MoM). The performance of screening by a combination of maternal history and podocalyxin levels was assessed with ROC curves.

Results

SGA was predicted by maternal age, height, South Asian ethnicity, and previous delivery without pre-eclampsia. Median podocalyxin levels were higher in affected than uncomplicated pregnancies (1.303 versus 0.994 MoM, p < 0.001). At a 10% false-positive rate, maternal history identified 40.0% of the cases (AUC = 0.74, 95%CI 0.671–0.809). The addition of podocalyxin increased the detection to 54.3% (AUC = 0.78, 95%CI 0.771–0.842, p = 0.027 for the difference in ROC curves).

Conclusion

First-trimester podocalyxin may be useful in screening for SGA infants.

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Acknowledgements

We thank all the patients for donating blood samples for this study.

Funding

This work was supported by National Health and Medical Research Council of Australia (Fellowship#1041835 and project grant #1108365 to GN), Bill and Melinda Gates Foundation, and the Victorian State Government Operational Infrastructure Scheme.

Author information

Author notes

  1. These authors contributed equally: Daniel Lorber Rolnik, Yao Wang

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia

    Daniel Lorber Rolnik & Fabricio da Silva Costa

  2. Implantation and Placental Development Laboratory, Centre for Reproductive Health, Hudson Institute of Medical Research, Melbourne, VIC, Australia

    Yao Wang & Guiying Nie

  3. Department of Molecular and Translational Science, Monash University, Melbourne, VIC, Australia

    Yao Wang & Guiying Nie

  4. University of Sydney, Sydney, NSW, Australia

    Jonathan Hyett

  5. RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia

    Jonathan Hyett

  6. Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil

    Fabricio da Silva Costa

  7. Department of Biochemistry and Molecular Biology, Monash University, Melbourne, VIC, Australia

    Guiying Nie

Authors
  1. Daniel Lorber Rolnik
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Contributions

FdSC, GN, and JH conceptualized the study. JH provided the patient samples. YW performed the laboratory analysis under the supervision of GN. DLR did the statistical analysis, and DLR and YW wrote the manuscript. All authors reviewed the final version of the manuscript.

Corresponding author

Correspondence to Guiying Nie.

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Rolnik, D.L., Wang, Y., Hyett, J. et al. Serum podocalyxin at 11–13 weeks of gestation in the prediction of small for gestational age neonates. J Perinatol 39, 784–790 (2019). https://doi.org/10.1038/s41372-019-0370-5

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