Maternal Serum Placental Leucine Aminopeptidase as a Predictor of Pregnancy Outcomes


BACKGROUND:Placental leucine aminopeptidase is a glycoprotein, known as oxytocinase. It helps to maintainnormal pregnancy to term, also it is involved in fetal development, maintenance of homeostasisduring pregnancy, blood pressure regulation, memory retention, antigen presentation, and cancerdevelopment.OBJECTIVE:To evaluate the value of maternal serum placental leucine aminopeptidase levels as a predictor ofpregnancy outcomes.PATIENTS AND METHODS:Hundred pregnant women were included in the study, they were divided into four groups, 25pregnant women with hypertensive disorder of pregnancy, 25 pregnant women with gestationaldiabetes and 25 pregnant women with intrauterine fetal death at a gestational age between 28 - 41weeks, another 25 healthy pregnant women as a control group with gestational age range 37 - 40weeks. Serum levels of placental leucine aminopeptidase were measured using Enzyme-linkedimmunosorbent assay (ELISA) method for all study groups at the time of presentation. It is a case -control study that was conducted at AL-Yarmook Teaching Hospital, department of obstetrics andgynecology.RESULTS:Serum placental leucine aminopeptidase concentration significantly lower in pregnant womenpresented with fetal death group was(mean ± SD)61.6 ± 15.8IU/ml compared to pregnant womenwith hypertensive disorders in pregnancy, gestational diabetes mellitus and healthy pregnant womenwere (83.2 ± 12.51IU/mL, 85.0 ± 13.11IU/mL and 108.9 ± 19.1IU/mL), respectively. Receiveroperating characteristic( ROC) curve analysis showed that the result of serum placental leucineaminopeptidase level for predicting perinatal mortality among pregnant women was (optimal cutpoint ≤78.98, sensitivity100%, specificity 73.3and accuracy 80.0%).CONCLUSION:Maternal serum placental leucine aminopeptidase was low among patients with hypertensivedisorders in pregnancy, gestational diabetes mellitus and much lower among patients presented withfetal death compared to healthy pregnant women. Low serum placental leucine aminopeptidase levelhad high sensitivity and specificity for predicting perinatal mortality.