Pregnancy outcome in women with low midtrimester maternal serum unconjugated estriol.
OBJECTIVE
To determine if unexplained low second-trimester maternal serum unconjugated estriol (MSuE3) is a useful predictor of complications of pregnancy.


METHODS
Between February 1, 1990, and January 3, 1993, 10,492 patients underwent prenatal screening using second-trimester maternal serum alpha-fetoprotein (MSAFP), maternal serum human chorionic gonadotropin (MShCG) and MSuE3. One hundred ninety-five patients with complete obstetric history/delivery records and with < 0.4 multiples of the median (MoM) second-trimester MSuE3 values were matched with 261 controls with complete obstetric history/delivery records and normal second-trimester MSAFP, MSuE3 and MShCG.


RESULTS
The relative risk of pregnancy loss, as compared to that in controls, was 3.7 (1.4-9.1 confidence interval [CI], P < .0001) in patients with 0.2-0.4 MoM MSuE3 and 19.3 (6.1-60.5 CI, P < .0001) in patients with < 0.2 MoM MSuE3. After exclusion of patients with low and high MSAFP and MShCG, the relative risk of pregnancy loss for the remaining patients with low MSuE3 was 3.3 (1.3-8.5 CI, P < .008).


CONCLUSIONS
The data suggest that patients with unexplained low second-trimester MSuE3 have an increased risk of pregnancy loss that may not be associated with a high or low MSAFP, MShCG or higher incidence of pregnancy-induced hypertension, gestational diabetes, premature rupture of membranes or premature onset of labor.
Santolaya-Forgas
J
J
Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, USA.
Jessup
J
J
Burd
L I
LI
Prins
G S
GS
Burton
B K
BK
D000328:Adult; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood; D004964:Estriol / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second / Q000097:blood*; D011296:Prenatal Diagnosis; D012306:Risk; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000378:metabolism
D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins; D004964:Estriol