Investigation of Association with First-Trimester Free Human Chorionic Gonadotropin-ß, Pregnancy - Associated Plasma Protein-A, and Adverse Pregnancy Outcomes

Authors

DOI:

https://doi.org/10.21613/GORM.2021.1158

Keywords:

Fetal growth restriction, Gestational hypertension, Human chorionic gonadotrophin beta subunit, Nuchal translucency, Preeclampsia, Pregnancy-associated plasma protein A

Abstract

OBJECTIVES: This study aimed to investigate the association between first-trimester screening maternal serum markers (free human chorionic gonadotropin-beta (β-hCG), pregnancy-associated plasma protein-A, and adverse pregnancy outcomes (gestational hypertension, preeclampsia, preterm delivery, intrauterine growth restriction, oligohydramnios, intrauterine ex-fetus, abruptio placentae, and gestational diabetes mellitus).

STUDY DESIGN: This was a retrospective cohort study including 1516 women who delivered a singleton pregnancy at GATA Haydarpasa Education Hospital from 2006 to 2009. Patients with multiple pregnancies, chromosome aberrations, or fetal anomalies were excluded. Extreme values of corrected- pregnancy-associated plasma protein-A and free β-hCG, and their association with adverse pregnancy outcomes were analyzed.

RESULTS: Adverse pregnancy outcomes at the cutoff level of ≤0.25 c-pregnancy-associated plasma protein-A MOM values positive likelihood ratio (+LR) was 7.5 (95%CI 2.426-19.836) and had a significant correlation (r=0.108, p<0.01). It was also a significant correlation with adverse pregnancy outcomes (r=0.189, p<0.01) at the cut-off level of ≤0.50 corrected-pregnancy-associated plasma protein-A MOM values and the +LR was 2.388 (95%CI 1.889-2.991). Association between low corrected-pregnancy-associated plasma protein-A MOM values and adverse pregnancy outcomes were statistically significant and had a poor association (AUC, 0.630 95%CI 0.596-0.663, p<0.01). Preeclampsia was statistically significant, however had a fair association (AUC, 0.74 95% CI 0.690-0.802, p<0.01). Preterm birth was statistically significant but had a poor association (AUC, 0.568 95% CI 0.512-0.624, p<0.05).

CONCLUSION: First-trimester maternal serum low pregnancy-associated plasma protein-A values are significantly associated with adverse pregnancy outcomes. It may be a useful tool to predictive not only chromosome anomalies but also adverse pregnancy outcomes.

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Published

2022-03-30

How to Cite

1.
Gonen G, Kemal Akpak Y, Muhcu M. Investigation of Association with First-Trimester Free Human Chorionic Gonadotropin-ß, Pregnancy - Associated Plasma Protein-A, and Adverse Pregnancy Outcomes. Gynecol Obstet Reprod Med [Internet]. 2022Mar.30 [cited 2022May20];28(1):7-15. Available from: https://gorm.com.tr/index.php/GORM/article/view/1158

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Section

Obstetrics; Maternal Fetal Medicine and Perinatology

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