Abstract

BACKGROUND:
Placental leucine aminopeptidase is a glycoprotein, known as oxytocinase. It helps to maintain
normal pregnancy to term, also it is involved in fetal development, maintenance of homeostasis
during pregnancy, blood pressure regulation, memory retention, antigen presentation, and cancer
development.
OBJECTIVE:
To evaluate the value of maternal serum placental leucine aminopeptidase levels as a predictor of
pregnancy outcomes.
PATIENTS AND METHODS:
Hundred pregnant women were included in the study, they were divided into four groups, 25
pregnant women with hypertensive disorder of pregnancy, 25 pregnant women with gestational
diabetes and 25 pregnant women with intrauterine fetal death at a gestational age between 28 - 41
weeks, another 25 healthy pregnant women as a control group with gestational age range 37 - 40
weeks. Serum levels of placental leucine aminopeptidase were measured using Enzyme-linked
immunosorbent 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 and
gynecology.
RESULTS:
Serum placental leucine aminopeptidase concentration significantly lower in pregnant women
presented with fetal death group was(mean ± SD)61.6 ± 15.8IU/ml compared to pregnant women
with hypertensive disorders in pregnancy, gestational diabetes mellitus and healthy pregnant women
were (83.2 ± 12.51IU/mL, 85.0 ± 13.11IU/mL and 108.9 ± 19.1IU/mL), respectively. Receiver
operating characteristic( ROC) curve analysis showed that the result of serum placental leucine
aminopeptidase level for predicting perinatal mortality among pregnant women was (optimal cut
point ≤78.98, sensitivity100%, specificity 73.3and accuracy 80.0%).
CONCLUSION:
Maternal serum placental leucine aminopeptidase was low among patients with hypertensive
disorders in pregnancy, gestational diabetes mellitus and much lower among patients presented with
fetal death compared to healthy pregnant women. Low serum placental leucine aminopeptidase level
had high sensitivity and specificity for predicting perinatal mortality.