Association of maternal serum Netrin-1 and Netrin-4 levels with placenta accreta spectrum

OBJECTIVE: This study aimed to evaluate maternal serum Netrin-1 and Netrin-4 levels in pregnancies complicated with placenta accreta spectrum.PATIENTS AND METHODS: This cross-sec-tional study enrolled 49 pregnant women with the diagnosis of placenta accreta spectrum as the study group. Gestational age-matched 30 uncomplicated pregnant women with prior ce-sarean delivery and normal placentation were randomly selected as the control group. Mater-nal serum Netrin-1 and Netrin-4 levels were mea-sured between weeks 34 and 36 of gestation.RESULTS: There was no significant difference between the groups in terms of demographic characteristics. Maternal serum Netrin-1 levels were significantly lower in placenta accreta spec-trum cases compared with those in the control group (p=0.038). There was no significant differ-ence between the groups in terms of maternal se-rum Netrin-4 levels (p>0.05). There was a signif-icant negative correlation between maternal se-rum Netrin-1 levels and the number of prior ce-sarean deliveries (r=-0.313, p=0.005).CONCLUSIONS: The observed decrease in maternal serum Netrin-1 levels in placenta ac-creta spectrum cases associated with increased angiogenesis might be one of the factors in-volved in the pathophysiology of this disease.