Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

BACKGROUND: A hypoxic intrauterine environment is believed to play a pivotal role in physiological trophoblast development. Ischaemia-modified albumin (IMA) is used in the measurement of cardiac ischaemia. We aimed to test the hypothesis that maternal serum IMA may be elevated in early pregnancy as a measurable manifestation of intrauterine ischaemia. METHODS: Prospective observational study in healthy women with singleton pregnancies (n=66) and non-pregnant controls (n=26). Maternal serum IMA levels were measured at 11-13 weeks of gestation and in non-pregnant women. RESULTS: The median IMA level in the pregnant group [115.14 kU/l; interquartile range (IQR) 102.33-124.71 kU/l] was significantly higher (P<0.001) than in non-pregnant controls (73.71 kU/l; IQR 60.38-82.78 kU/l). During pregnancy, absolute values of IMA were higher than the concentration used for the diagnosis of myocardial ischaemia (>95 kU/l) in 86% of women. CONCLUSIONS: In early pregnancy, IMA levels were above the concentration used for the diagnosis of myocardial ischaemia in most women, and should therefore not be used as a marker for cardiac ischaemia in pregnancy. Maternal serum IMA is elevated to supra-physiological levels in early normal pregnancy supporting the hypothesis that normal trophoblast development is associated with a hypoxic intrauterine environment, although other mechanisms leading to an IMA increase cannot be excluded.

Original publication




Journal article


Hum Reprod

Publication Date





2029 - 2032


Adult, Biomarkers, Female, Gestational Age, Humans, Hypoxia, Ischemia, Pregnancy, Pregnancy Trimester, First, Serum Albumin, Trophoblasts