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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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First trimester maternal serum placental protein 13 levels in singleton vs. twin pregnancies with and without severe pre-eclampsia

Ran Svirsky
  • Ultrasound Institute, Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
/ Hamutal Meiri
  • Hy-Laboratories Ltd, Rehovot Science Park, Rehovot, Israel
  • TeleMarpe Ltd, Tel Aviv, Israel
/ Ayelet Herzog
  • Hy-Laboratories Ltd, Rehovot Science Park, Rehovot, Israel
/ Vered Kivity
  • TeleMarpe Ltd, Tel Aviv, Israel
/ Howard Cuckle
  • Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY, USA
/ Ron Maymon
  • Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, 70300, Israel
  • :
Published Online: 2013-05-16 | DOI: https://doi.org/10.1515/jpm-2013-0011


Aims: To determine first trimester maternal serum placental protein 13 (PP13) in singletons vs. twins with and without severe preeclampsia (PE).

Methods: Serum samples were prospectively collected at 8–14 weeks of gestation. PP13 was determined by solid-phase immunoassay. Patients were recruited in community clinics throughout the country, and from the twin antenatal assessment clinic in Assaf Harofeh Medical Center, Zerifin, Israel. Demographics, medical, and pregnancy history were obtained at enrollment. Pregnancy outcome was collected after delivery. PP13 was compared by the Wilcoxon rank sum test.

Results: In singletons, PP13 declined with maternal weight and was lower in in vitro fertilization. Levels were converted into multiples of the median (MoMs) accordingly. In twins, the median was 1.74 MoM (n=76) vs. 1.00 in singletons (n=676, P<0.0001). Among twins with severe PE (n=10), the median was 1.53 MoM vs. 1.74 in unaffected twins (P=0.10), and 2.26 (n=6) for mild PE (P=0.30). Among singletons with severe PE, the median was 0.44 MoM (n=26, P<0.0001), and for mild PE 0.62 (n=17, P<0.001).

Conclusion: PP13 is higher in twins than singletons, corresponding to the larger placental mass. Among singletons with severe PE, levels were significantly reduced, however, among twins, only a non-significant tendency for a reduction was recorded, and warrants further investigation in a larger series.

Keywords: Placental protein 13; prediction; pre-eclampsia; serum biomarkers; twins

Corresponding author: Prof. Ron Maymon, MD, Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, 70300, Israel, Tel.: +972-3-5245892, Fax: +972-3-5246867

Received: 2013-01-18

Accepted: 2013-04-12

Published Online: 2013-05-16

Published in Print: 2013-09-01

Citation Information: Journal of Perinatal Medicine. Volume 41, Issue 5, Pages 561–566, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2013-0011, May 2013

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