title: Elevated second-trimester human chorionic gonadotropin and subsequent pregnancy-induced hypertension.
abstract: OBJECTIVE
  Pregnancy-induced hypertension is believed to be a disorder of the vascular endothelium, possibly focused in the placenta. Markers such as cellular fibronectin appear early in patients in whom pregnancy-induced hypertension develops. We hypothesized that patients with elevated second-trimester levels of human chorionic gonadotropin would have an increased risk for pregnancy-induced hypertension.
  
  
  METHODS
  We conducted a cohort study, using a database of patients undergoing second-trimester serum screening for Down syndrome and who were delivered at our institution between January 1990 and August 1991. We included all 180 women with human chorionic gonadotropin levels > or = 2.0 multiples of the median. A sequential sample of 369 women with levels < 2.0 multiples of the median served as the referent group. Standard American College of Obstetricians and Gynecologists definitions of pregnancy-induced hypertension and proteinuria were used.
  
  
  RESULTS
  Patients with elevated human chorionic gonadotropin levels were at increased risk for pregnancy-induced hypertension (risk ratio 1.7, 95% confidence interval 1.2 to 2.4) and proteinuric pregnancy-induced hypertension (risk ratio 5.1, 95% confidence interval 1.6 to 16.2). Adjusting for potential confounding factors did not alter these associations.
  
  
  CONCLUSIONS
  Patients with elevated human chorionic gonadotropin appear to be at higher risk of pregnancy-induced hypertension and proteinuric pregnancy-induced hypertension. Second-trimester human chorionic gonadotropin levels should be further investigated as a potential marker for pregnancy-induced hypertension.
authors.affiliation: Division of Perinatal Medicine, Swedish Medical Center/Seattle, WA 98104.
authors.forename: T K
authors.initials: TK
authors.lastname: Sorensen
authors.forename: M A
authors.initials: MA
authors.lastname: Williams
authors.forename: R W
authors.initials: RW
authors.lastname: Zingheim
authors.forename: S J
authors.initials: SJ
authors.lastname: Clement
authors.forename: D E
authors.initials: DE
authors.lastname: Hickok
mesh_terms: D000328:Adult; D015415:Biomarkers; D006063:Chorionic Gonadotropin / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin