importance of maternal ischemia modified albumin, non stress test and doppler ultrasonography in foreseeing perinatal asphyxia

Background: The aim of this study is to evaluate the importance of ischemia changed albumin, in foreseeing fetal asphyxia and comparing it between normal and preeclamptic pregnant. Method: We planned our study as a prospective case-controlled study between May 2011 and June 2013. We recruited 104 pregnant women complicated by preeclampsia and 110 healthy pregnant women in the study. Doppler ultrasonography, non-stress test and fetal biometric measurements were performed. Venous blood samples taken to measure ischemia modified albumin (IMA). The presence of fetal hypoxia/acidosis was analyzed by conducting post-natal cord blood gas examination and 1.-5. minutes APGAR scoring. Results: Women with preeclampsia had higher IMA compared to controls. The correlations between umbilical artery doppler systolic/diastolic (S/D) ratio, brain sparing effect, non stress test and IMA analyzed. We have found IMA statistically high when S/D ratio is above 2 standard deviations (preeclampsia; 11.83±1.33 vs 19.62±1.56 p<0.001, control; 10.28±1.57 vs 18.09±2.13 p<0.001) or brain sparing effect started (preeclampsia; 25.59±2.48 vs 9.16±1.99 p<0.001, control; 16.37±1.97 vs 6.72± 1.53 p<0.001) or abnormal NST findings occurred (preeclampsia; 10.69±1.92 vs 20.72±1.15 p<0.001, control; 7,42±1,94 vs 9,72±2,19 p<0.001). Conclusions: Maternal IMA levels are found high in preeclamptic pregnant women and it can be used as a biomarker for determining fetal wellbeing.

Increase in Ischemia-Modified Albumin and Pregnancy-Associated Plasma Protein-A in COVID-19 Patients

This study was undertaken due to the urgent need to explore reliable biomarkers for early SARS-CoV-2 infection. We performed a retrospective study analyzing the serum levels of the cardiovascular biomarkers IL-6, TNF-α, N-terminal pro-B natriuretic peptide, cardiac troponin T (cTnT), ischemia-modified albumin (IMA) and pregnancy-associated plasma protein-A (PAPP-A) in 84 patients with COVID-19.Patients were divided into three groups according to their RT-qPCR and IgG values: acute infection (n = 35), early infection (n = 25) or control subjects (n = 24). Levels of biomarkers were analyzed in patient serum samples using commercially available ELISA kits. Results showed a significant increase in IMA and PAPP-A levels in the early infected patients. Moreover, multivariate analysis and receiver operating characteristic (ROC) curve showed that IMA and PAPP-A had excellent discrimination value for the early stage of COVID-19. For IMA, the area under the ROC curve (AUC) had a value of 0.94 (95% confidence interval (CI): 0.881–0.999). Likewise, the serum level of PAPP-A was significantly higher in patients with early infection than in the control subjects (AUC = 0.801 (95% CI: 0.673–0.929)). The combined use of IMA and PAPP-A enhanced the sensitivity for total SARS-CoV-2-infected patients to 93%. These results suggest that the increased levels of PAPP-A and IMA shed light on underlying mechanisms of COVID-19 physiopathology and might be used as efficient biomarkers with high sensitivity and specificity for the early stage of COVID-19. Importantly, when monitoring pregnancy and cardiovascular diseases using PAPP-A or IMA levels, a SARS-CoV-2 infection should be discarded for proper interpretation of the results.

Cord Blood Ischemia-Modified Albumin Levels in Preterm Infants with Intrauterine Growth Restriction

Background Intrauterine growth restriction (IUGR) is one of the causes of perinatal mortality and morbidity. It is the failure of the fetus to achieve intrinsic growth potential. Since IUGR neonates are more likely to suffer complications including perinatal asphyxia, cold stress, hypoglycemia, hypocalcaemia, hyperbilirubinemia, feed intolerance, NEC, sepsis and even mortality. So, it is important that these infants are identified and managed appropriately at birth. Purpose The present study aims to determine the possible association between cord blood ischemia-modified albumin (IMA) levels and intrauterine growth restriction (IUGR) in preterm infants with or without complicated gestations. Patients and Method Eighty mothers and their preterm neonates (&lt;37 weeks’ gestation) identified in 2 groups according to antenatal ultrasound: a group with prospective antenatal diagnosis of IUGR and the other group with normal fetal development, after consideration of inclusion and exclusion criteria. Cord blood Albumin and Ischemia modified albumin were estimated by double-antibody sandwich Enzyme-Linked Immunosorbent Assay (ELISA). Results Cord blood IMA was significantly higher in IUGR group compared to control group. Consequently, albumin level was significantly lower in IUGR group compared to other group. IMA was inversely correlation with Hb level and albumin level was inversely correlated with liver function tests (ALT and AST). Conclusion There is a positive association between IMA level and IUGR. This sent a message that combined antenatal ultrasound and serum IMA is a better predictor of intrauterine growth restriction and subsequent better care of neonates with IUGR.