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Low kisspeptin levels in early pregnancy could predict miscarriage
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CHICAGO — Low measures of single plasma kisspeptin in early pregnancy could predict miscarriage in pregnant women without symptoms, according to research presented at the joint meeting of the International Congress of Endocrinology and the Endocrine Society.
The study is the first to demonstrate that a single blood sample could provide a highly predictive marker, surpassing human chorionic gonadotropin (hCG) as a common diagnostic hormone to identify miscarriage risk. Watch a video perspective on this data »
“Blood kisspeptin levels are lower in asymptomatic pregnant women who subsequently suffer miscarriage when compared with women who do not miscarry,” Ali Abbara, MBBS, BSc, MRCP, clinical research fellow at Imperial College London, United Kingdom, said during his presentation. “It was also more predictive for the occurrence of miscarriage than the more widely used pregnancy hormone hCG.”
In a prospective cohort study in a single tertiary obstetric center in London, Abbara and colleagues looked at 993 asymptomatic pregnant women (mean gestation of 11.2 weeks, range 5.9-29.0 weeks) over a period of 2 years.
Using in-house radioimmunoassay, the investigators evaluated plasma kisspeptin and serum blood HCG during routine prenatal exams, then prospectively recorded pregnancy outcome.
Plasma kisspeptin levels were strongly associated with gestational week of pregnancy (r2=0.57; P<.0001). Using multiples of median, gestational age-corrected plasma kisspeptin levels were 60.4% lower and hCG was 36.1% lower (P<.001 for both) in women who later miscarried vs. those who did not.
A strong association was found between plasma kisspeptin >1306 pmol/L and a reduced risk of miscarriage, even after adjustments for age, body mass index, gestational age, smoking and blood pressure (OR=0.13; P=.0001).
Plasma kisspeptin had a higher diagnostic performance for miscarriage when compared with hCG (area under curve: 0.899±0.025, plasma kisspeptin; 0.775±0.040, serum hCG, P<.01 vs. plasma kisspeptin).
Future work will assess whether enhanced surveillance or investigation could alter the course of miscarriage.
“It’s possible that if you are able to identify these women at a very, very early stage that you may be able to target investigation and treatments for these women,” Abbara said. “The next step would be to try and, in real-time, identify women with low kisspeptin levels and look to see if we can investigate these women to see if there are reversible causes. — by Allegra Tiver
Watch a video perspective on this data »
For More Information: Abbara A. Abstract OR04-2. Presented at: The joint meeting of the International Congress of Endocrinology and the Endocrine Society; June 21-24, 2014; Chicago.
Disclosures: Abbara reports no relevant disclosures.