Circulating serine peptidase inhibitor, Kunitz type 1(SPINT1) –A biomarker of pregnancies with poor placental function and fetal growth restriction

• Author Details:   
• Divia Paul Aricatt ^*
• Joylene Diana D'almeida
• Ranajit Das
• Ashwini Prabhu
• Cleeta Rebeiro

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Introduction: Placental insufficiency and fetal growth restriction significantly contributed to stillbirth risk, particularly in India, where reliable maternal and newborn health statistics were scarce. The aim of this study was to investigate serum SPINT1 levels as a biomarker for detecting placental insufficiency potentially easing the global burden of preventable stillbirths. Therefore, the study’s objective is to assess circulating SPINT1 levels at 28-36 weeks gestation to determine its effectiveness as a biomarker for placental insufficiency.

Materials and Methods: This prospective cohort study recruited 77 pregnant participants through convenience sampling, following ethical approvals and informed consent. Clinical data were collected, and serum SPINT1 levels were measured using enzyme-linked immunosorbent assay (ELISA) during 28-36 weeks of gestation. Postnatal follow-up evaluated neonatal outcomes through APGAR scores, focusing on cases with fetal complications. Statistical analyses were conducted using GraphPad Prism v9.

Results: The highest serum SPINT1 levels were observed at 28 weeks, with a significant correlation found with gestational age (r = 0.54, p = 0.004) and systolic blood pressure (r = 0.45, p < 0.0001). Multiple linear regression identified age, hemoglobin, and blood pressure as significant predictors of SPINT1 levels (p = 0.0022). Low APGAR scores were noted in five cases, indicating a link between impaired neonatal outcomes and placental insufficiency.

Conclusion: Serum SPINT1 had the potential to enhance early detection of placental insufficiency, improving management strategies for high-risk pregnancies. Further research was necessary to confirm these findings and explore broader clinical applications.