Am J Perinatol
DOI: 10.1055/a-2125-1330
Original Article

Serum ADAMTS-9 Level in Newborn Babies with Congenital Heart Disease

1   Department of Neonatology, Ankara City Hospital, Neonatal Intensive Care Unit, University of Health Sciences, Ankara, Turkey
1   Department of Neonatology, Ankara City Hospital, Neonatal Intensive Care Unit, University of Health Sciences, Ankara, Turkey
2   Department of Neonatology, Yildirim Beyazit University Faculty of Medicine, Ankara Turkey
1   Department of Neonatology, Ankara City Hospital, Neonatal Intensive Care Unit, University of Health Sciences, Ankara, Turkey
3   Department of Medical Biochemistry, Harran University, Urfa, Turkey
1   Department of Neonatology, Ankara City Hospital, Neonatal Intensive Care Unit, University of Health Sciences, Ankara, Turkey
4   Cardiology Department, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
5   Department of Medical Biochemistry, Sağlık Bilimleri Üniversitesi Gülhane Tıp Fakültesi, Health Science University Ankara, Turkey
› Author Affiliations
Funding None.


Objective A Disintegrin and Metalloproteinase with Thrombospondin-9 (ADAMTS-9), one of the ADAMTS enzymes, is expressed in all fetal tissues, unlike other ADAMTS enzymes, and is thus thought to play a role in fetal development. In this context, the objective of this study is to investigate the relationship between ADAMTS-9 activity and the development of congenital heart diseases (CHD) with a view to using ADAMTS-9 level as a biomarker for CHDs.

Study Design Newborns diagnosed with CHD and healthy newborns were included in the study as the CHD and control groups, respectively. Gestational age, maternal age, and mode of delivery information pertaining to the mothers and Apgar score and birthweight information pertaining to the newborns were recorded. Blood samples were taken from all newborns to determine their ADAMTS-9 levels in the first 24 hours of life.

Results Fifty-eight newborns with CHD and 46 healthy newborns were included in the study. Median ADAMTS-9 levels were 46.57 (interquartile range [IQR]: 33.31 [min: 26.92, max: 124.25]) and 23.36 (IQR: 5.48 [min: 11.7, max: 37.71]) ng/mL in the CHD and control groups, respectively. ADAMTS-9 levels in the CHD group were statistically significantly higher than in the control group (p = 0.000). ADAMTS-9 levels of the CHD and control groups were analyzed by the receiver operating characteristics curve. The area under the curve value for ADAMTS-9 levels of >27.86 ng/mL as the cut-off value for predicting the development of CHD in newborns was 0.836 (95% confidence interval [CI]: 0.753–0.900, p = 0.0001). ADAMTS-9 levels of >27.86 ng/mL were determined to predict the development of CHD in newborns with a sensitivity of 77.78% (95% CI: 65.5–87.38) and a specificity of 84.78% (95% CI: 71.1–93.60).

Conclusion In conclusion, it was found that the serum ADAMTS-9 levels were significantly higher in newborns with CHD than in healthy newborns. In parallel, ADAMTS-9 levels above a certain cut-off value were associated with CHD.

Key Points

  • ADAMTS-9 is expressed in fetal tissues.

  • Its level increases in congenital heart diseases.

  • It can be used as a biochemical marker in diagnosis.

Authors' Contributions

C.B., A.K., B.C., and C.T. conceptualized and designed the study, drafted the initial manuscript. C.T., I.K., and C.B. carried out the initial analyses, reviewed, and revised the manuscript. U.C., K.T., and M.K. supervised the statistics. C.T., K.T., and A.K. made critical revision of the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. The authors declare that all data were generated in-house and that no paper mill was used. All authors read and approved the manuscript and all data were generated in-house and that no paper mill was used

Publication History

Received: 13 December 2022

Accepted: 06 July 2023

Accepted Manuscript online:
07 July 2023

Article published online:
14 August 2023

© 2023. Thieme. All rights reserved.

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