Study summary · research use only
Increased maternal serum activin A but not follistatin levels in pregnant women with hypertensive disorders
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This controlled survey in an academic prenatal unit compared serum follistatin and activin A levels in pregnant women in the last trimester. Healthy pregnant controls (n=38) were compared with women with pregnancy-induced hypertension (PIH, n=18), pre-eclampsia (n=16), and a subset with pre-eclampsia plus intrauterine growth restriction (n=5). The authors report follistatin levels did not differ between controls and patients, while activin A, expressed as multiples of the median, was significantly increased in PIH (1.8 MoM), pre-eclampsia (4.6 MoM), and pre-eclampsia plus growth restriction (3.2 MoM). The activin A to follistatin ratio was also increased in these groups. Follistatin correlated positively with gestational age in several groups. The authors suggest unbound, biologically active activin A is increased in women with these gestational disorders.
Abstract
Activin A levels are elevated in maternal serum of pregnant women with hypertensive disturbances. Because follistatin is a circulating binding protein for activin A, the present study was designed to evaluate whether serum follistatin and activin A levels also change in patients with hypertensive disorders in the last gestational trimester. The study design was a controlled survey performed in the setting of an academic prenatal care unit. Healthy pregnant women (controls, n=38) were compared with patients suffering from pregnancy-induced hypertension (PIH, n=18) or pre-eclampsia (n=16). In addition, the study included a subset of patients with pre-eclampsia associated with intrauterine growth restriction (IUGR, n=5). Maternal blood samples were withdrawn at the time of diagnosis (patients) or in a random prenatal visit (controls), and serum was assayed for follistatin and activin A levels using specific enzyme immunoassays. Hormone concentrations were corrected for gestational age by conversion to multiples of median (MoM) of the healthy controls of the same gestational age. Follistatin levels were not different between controls and patients, while activin A levels were significantly increased in patients with PIH (1.8 MoM), pre-eclampsia (4.6 MoM), and pre-eclampsia+IUGR (3.2 MoM, P<0.01, ANOVA). The ratio between activin A and follistatin was significantly increased in patients with PIH (1.5 MoM) and was further increased in patients with pre-eclampsia (4.5 MoM) and in the group with pre-eclampsia+IUGR (2.6 MoM). Follistatin levels were positively correlated with gestational age in control subjects (r=0. 36, P<0.05) and in patients with PIH (r=0.46, P<0.05) or pre-eclampsia (r=0.61, P<0.01), while activin A correlated with gestational age only in the healthy control group (r=0.69, P<0.0001). The finding of apparently normal follistatin and high activin A levels in patients with PIH and pre-eclampsia suggests that unbound, biologically active, activin A is increased in women with these gestational diseases.
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