title: Maternal serum levels of free beta-hCG and PAPP-A in the first trimester of pregnancy are not associated with subsequent fetal growth retardation or preterm delivery.
abstract: The purpose of this case-control study was to examine the association of first-trimester concentrations of free beta-human chorionic gonadotropin (free beta-hCG) and pregnancy-associated plasma protein A (PAPP-A) in maternal serum with subsequent preterm delivery or small-for-gestational age (SGA) fetuses. We collected all the blood samples before chorionic villus sampling in the first trimester. Concentrations of free beta-hCG and PAPP-A were expressed in multiples of the median (MOM) for gestational age. We compared the levels of both analytes in 73 SGA pregnancies (birth weight below the fifth percentile) with those in 292 normal controls, who were matched for gestational age, maternal age, parity, maternal weight, and smoking habits. We also compared the levels in 87 pregnancies with a preterm delivery (delivery before 37 completed weeks) with those in 348 matched controls. The median concentrations of PAPP-A and free beta-hCG, expressed in MOMs, in the 73 SGA pregnancies were 0.83 and 0.95, respectively, compared with 0.98 and 1.01, respectively, in the 292 matched controls (P=0.08 and 0.19, respectively). In the 87 pregnancies with a preterm delivery, the median concentrations of PAPP-A and free beta-hCG were 0.98 and 0.94, respectively, compared with 0.99 and 0.99, respectively, in the 348 matched controls (P=0.82 and 0.10, respectively). In contrast with the maternal serum analytes used in second-trimester screening--alpha-fetoprotein and human chorionic gonadotropin--this study showed that concentrations of PAPP-A and free beta-hCG in the first trimester were not associated with subsequent fetal growth retardation or preterm delivery.
authors.affiliation: Department of Obstetrics and Gynaecology, Antenatal Diagnosis Unit, University Hospital Groningen, The Netherlands.
authors.forename: L P
authors.initials: LP
authors.lastname: Morssink
authors.forename: L H
authors.initials: LH
authors.lastname: Kornman
authors.forename: T W
authors.initials: TW
authors.lastname: Hallahan
authors.forename: M D
authors.initials: MD
authors.lastname: Kloosterman
authors.forename: J R
authors.initials: JR
authors.lastname: Beekhuis
authors.forename: B T
authors.initials: BT
authors.lastname: de Wolf
authors.forename: A
authors.initials: A
authors.lastname: Mantingh
mesh_terms: D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D005317:Fetal Growth Retardation; D005865:Gestational Age; D006801:Humans; D007236:Infant, Small for Gestational Age; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012016:Reference Values; D012189:Retrospective Studies
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A