Category: Basic Science
Poster Session IV
Postpartum hemorrhage (PPH) is associated with significant morbidity and is the leading cause of maternal mortality worldwide. Unfortunately, it is difficult to clinically predict. We hypothesized that an unbiased proteomics approach utilizing a population-based cohort of pre-delivery blood samples from PPH cases and controls may yield biomarkers of potential clinical utility. Our objective was to identify biomarkers in the blood that may predict PPH prior to delivery.
Study Design:
Maternal pre-delivery blood samples from 30 cases of PPH and 60 matched controls were procured from a nested cohort of >60,000 participants in a single institution perinatal repository. Self-identified race for cases and controls respectively were Hispanic White: 73.3% & 81%; Black: 10% & 13.7%; non-Hispanic white: 10% & 5.2%; Asian: 6.6% & 0%. PPH was defined for cases as a decrease in hematocrit by ≥10% or receipt of transfusion within 24 hours of delivery. Controls were matched 2:1 by age and delivery route. A spectrometry based proteomic analysis was used to identify proteins based on Intensity Based Absolute Quantitation (iBAQ). Statistical significance was defined by a q of < 0.05 after controlling for multiple comparisons.
Results:
Over 1000 proteins were identified; 26 were statistically significant and of a known, suspected, or theoretical molecular pathway related to bleeding or coagulation. 14 out of 26 were increased in cases compared to controls including Amyloid P component (APCS), Glutathione independent prostaglandin D2 synthase (PTGDS), Collectin-10 (COLEC10), Serpin Family A1 (SERPINA1/PAI1), and Serpin Family A11 (SERPINA11). 12 out of 26 were decreased in cases compared to controls including glutathione peroxidase 1 (GPX1), latexin (LXN), and myeloperoxidase (MPO). All with q values < 0.01.
Conclusion:
Our findings show higher levels of APCS, PTGDS, SERPINA1, SERPINA11, and lower levels of GPX1, LXN, and MPO prior to delivery in blood samples with subsequent PPH. Future work will require unbiased validation of these biomarkers in larger cohorts.
Julia Barsoum (she/her/hers)
Medical Student
The George Washington University School of Medicine and Health Sciences
Washington, District of Columbia, United States
Kirk Hansen, PhD
Principal Investigator of Hansen Lab
University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
Andra H. James, MD, MPH
Professor Emeritus
Duke University Medical Center
Durham, North Carolina, United States
Kjersti M. Aagaard, MD,PhD
Professor and Vice Chair of Research Department of Obstetrics and Gynecology, Division of MFM
Texas Children's and Baylor College of Medicine
Houston, Texas, United States
Alisa S. Wolberg, PhD
University of North Carolina Chapel Hill
Chapel Hill, North Carolina, United States
Homa K. Ahmadzia, MD, MPH
Assistant Professor
The George Washington University
Washington, District of Columbia, United States