Introduction/Background This study was conducted to analyze CA125 and HE4 levels in the early postpartum period

Methodology In a prospective study (OB/GYN Department, General Hospital, Celje, Slovenia) 277 women who were in the 1st-3rd day of postpartum period were included in the study. Biomarkers were analyzed with regard to each day of postpartum period (1st, 2nd and 3rd day after delivery) as well as regarding the method of delivery (vaginal delivery, elective and emergency cesarean section). CA 125 and HE4 were evaluated in consideration of their reference intervals, ≤ 35 IU/ml and ≤ 140 pmol/l (Elecsys CA 125 II® assay and Elecsys HE4® assay, Roche Diagnostics Ltd.).

Results Biomarkers levels with regard to method of delivery. Women in the vaginal delivery group had significantly higher levels of CA125 than the women in both cesarean section groups (vaginal delivery group, n=144, median=36.9 IU/ml, elective cesarean, n=82, median=28.6 IU/ml and emergency cesarean, n=44, median=26.1 IU/ml, p <.001). All HE4 measurements were within reference range; women in both cesarean section groups had significantly higher levels of HE4 than the women in the vaginal delivery group (elective cesarean, n=86, median=61.0 pmol/l, emergency cesarean, n=44, median=58.0 pmol/l and vaginal delivery group, n=147, median=54.0, p < .001). Biomarkers levels with regard to each day of postpartum period. A significant number of women had high levels of CA125 (>100 IU/mL), with a gradual decline during the first three postpartum days. However, there was not a statistically significant difference between groups. Again, all HE4 measurements were within reference range with a statistically significant decline during the second and third day after delivery (1st postpartum day, n=203, median=60.0 pmol/l vs 2nd, n=49, median=51.0 pmol/l and 3rd day, n=25, median=51.0 pmol/l, p < .001).

Conclusion HE4 is more reliable marker of malignancy during the early postpartum period than CA125.