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Changes in circulating kisspeptin levels during each trimester in women with antenatal complications

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Ali Abbara, Maya Al-Memar, Maria Phylactou, Elisabeth Daniels, Bijal Patel, Pei Chia Eng, Rans Nadir, Chioma Izzi-Engbeaya, Sophie Clarke, Edouard Millis, Tia Hunjan, Ewa Pacuszka, Lisa Yang, Paul Bech, Tricia Tan, Alexander Comninos, Tom Kelsey, Christopher Kyriacou, Hanine Fourie, Tom Bourne & 1 more Waljit Dhillo

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Context: Antenatal complications such as hypertensive disorders of pregnancy (HDP), fetal growth restriction (FGR), gestational diabetes (GDM), and preterm birth (PTB) are associated with placental dysfunction. Kisspeptin has emerged as a putative marker of placental function, but limited data exist describing circulating kisspeptin levels across all three trimesters in women with antenatal complications.

Objective: To assess whether kisspeptin levels are altered in women with antenatal complications.

Methods: Women with antenatal complications (n = 105) and those with uncomplicated pregnancies (n = 265) underwent serial ultrasound scans and blood sampling at the Early Pregnancy Assessment Unit at Hammersmith Hospital, UK, at least once during each trimester (March 2014 to March 2017). The women with antenatal complications (HDP [n = 32], FGR [n = 17], GDM [n = 35], PTB [n = 11], and multiple complications [n=10]) provided 373 blood samples and the controls provided 930 samples. Differences in circulating kisspeptin levels were assessed.

Participants: Women with antenatal complications: HDP (n=32), FGR (n=17), GDM (n=35) and PTB (n=11), and 10 women with multiple complications, provided 373 blood samples, and a further 265 controls provided 930 samples.

Results: Third-trimester kisspeptin levels were higher than controls in HDP but lower in FGR. The odds of HDP adjusted for gestational age, maternal age, ethnicity, BMI, smoking, and parity were increased by 30% (95% CI, 16%-47%; P < 0.0001), and of FGR were reduced by 28% (95% CI, 4-46%; P = 0.025), for every 1 nmol/L increase in plasma kisspeptin. Multiple of gestation-specific median values of kisspeptin were higher in pregnancies affected by PTB (P = 0.014) and lower in those with GDM (P = 0.020), but not significantly on multivariable analysis.

Conclusion: We delineate changes in circulating kisspeptin levels at different trimesters and evaluate the potential of kisspeptin as a biomarker for antenatal complications.


Original languageEnglish
Article numberdgab617
Number of pages13
JournalJournal of Clinical Endocrinology & Metabolism
VolumeAdvance Article
Early online date24 Aug 2021
Publication statusE-pub ahead of print - 24 Aug 2021

    Research areas

  • Fetal growth restriction (FGR), Intrauterine growth restriction (IUGR), Hypertensive diseases of pregnancy (HDP), Gestational diabetes (GDM), Preterm birth (PTB), Kisspeptin

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