ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Reproduction
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1627377
This article is part of the Research TopicPhysiology and Pathophysiology of PlacentaView all 5 articles
Decreased plasma APOA1 levels are associated with increased severity of placenta accreta spectrum disorders: a nested casecontrol study
Provisionally accepted
- Peking University Third Hospital, Haidian, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: Placenta accreta spectrum (PAS) disorders are a series of gestational diseases, with severe adverse outcomes. APOA1 is a lipid molecule that plays a role in cell invasion, inflammation and immune response. This study aimed to elucidate the relationship between APOA1 and PAS, as well as its adverse outcomes.Methods: This is a nested case-control study involving 118 patients with PAS and 118 non-PAS control women. Plasma APOA1 levels were evaluated at gestational weeks 24 +0 to 35 +6 by enzyme-linked immunosorbent assay. The clinical characteristics and pregnancy outcomes were recorded and analyzed in relation to APOA1 levels.The plasma APOA1 level in the PAS group was observed to be lower than that in the non-PAS group (p = 0.035). From 24 +0 to 35 +6 weeks of gestation, the trajectory of plasma APOA1 levels in the PP and placenta increta (PI) group exhibited a discernible decline. Maternal plasma APOA1 is a significant biomarker for the diagnosis of PAS and its adverse outcomes, particularly in the 32 +0 to 35 +6 weeks of gestation range for invasive PAS (AUC = 0.761, 95% CI 0.660-0.863, p < 0.001), PP (AUC = 0.889, 95% CI 0.801-0.976, p < 0.001), blood transfusion (AUC = 0.729, 95% CI 0.620-0.838, p < 0.001) and hysterectomy (AUC = 0.884, 95% CI 0.790-0.978, p < 0.001).A reduction in maternal plasma APOA1 levels was associated with the severity of PAS. APOA1 may serve as a biomarker for invasive PAS, blood transfusion and hysterectomy in late gestation.
Keywords: apolipoprotein A1, Plasma biomarker, Blood Transfusion, Hysterectomy, Invasive placenta accreta spectrum
Received: 12 May 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Zeng, Qu, Jiang, Shi, Yan, Zhao and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yu Yang Zhao, Peking University Third Hospital, Haidian, China
Lian Chen, Peking University Third Hospital, Haidian, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.