Maternal serum inhibin A can predict pre-eclampsia


Correspondence: Professor H. S. Cuckle, Centre for Reproduction, Growth and Development, Research School of Medicine, University of Leeds, 26 Clarendon Road, Leeds LS2 9NZ, UK.


Objective To compare median levels of maternal serum inhibin A in the second trimester blood samples of women who subsequently develop pre-eclampsia and those who do not.

Design Retrospective analysis of 13–18 week samples from a bank of serum stored at −40°C, originally taken for Down's syndrome screening.

Setting Antenatal clinics in a teaching hospital.

Sample Twenty-eight pregnancies with pre-eclampsia and 701 controls. Samples were taken, on average, 22 weeks before the diagnosis.

Main outcome measure Median inhibin A level.

Results The median inhibin A level in the cases was 2.01 multiples of the gestation-specific median in the controls, a statistically significant elevation (P < 0.001). Twenty-three (82%) had levels above the normal median; 19 (68%), 15 (54%), and 11 (39%) exceeded the normal 75th, 90th and 95th centiles, respectively.

Conclusions In pre-eclampsia the maternal serum inhibin A level can be increased months before the onset of symptoms. This provides an opportunity to study the early natural history of the disease and possibly to conduct treatment trials.