title: First trimester maternal serum free beta human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complications.
abstract: OBJECTIVE
  To examine the value of first trimester maternal serum free beta human chorionic gonadotrophin (beta hCG) and pregnancy associated plasma protein A (PAPP-A) as predictors of pregnancy complications.
  
  
  METHODS
  Screening study.
  
  
  METHODS
  Antenatal clinics.
  
  
  METHODS
  Singleton pregnancies at 10-14 weeks of gestation.
  
  
  METHODS
  Maternal serum free beta hCG and PAPP-A were measured at 10-14 weeks of gestation in 5,584 singleton pregnancies. In the 5,297 (94.9%) pregnancies with complete follow up free beta hCG and PAPP-A were compared between those with normal outcome and those resulting in miscarriage, spontaneous preterm delivery, pregnancy induced hypertension or fetal growth restriction and in those with pre-existing or gestational diabetes.
  
  
  RESULTS
  Maternal serum PAPP-A increased and beta hCG decreased with gestation. The multiple of median maternal serum PAPP-A was significantly lower in those pregnancies resulting in miscarriage, pregnancy induced hypertension, growth restriction and in those with pre-existing or gestational diabetes mellitus, but not in those complicated by spontaneous preterm delivery. The level was < 10th centile of the reference range in about 20% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 27% of those that developed gestational diabetes. Maternal serum free beta hCG was < 10th centile of the reference range in about 15% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 20% of those that developed gestational diabetes.
  
  
  CONCLUSIONS
  Low maternal serum PAPP-A or beta hCG at 10-14 weeks of gestation are associated with subsequent development of pregnancy complications.
authors.affiliation: Harris Birthright Research Center for Fetal Medicine, King's College Hospital Medical School, London, Denmark Hill, UK.
authors.forename: C Y
authors.initials: CY
authors.lastname: Ong
authors.forename: A W
authors.initials: AW
authors.lastname: Liao
authors.forename: K
authors.initials: K
authors.lastname: Spencer
authors.forename: S
authors.initials: S
authors.lastname: Munim
authors.forename: K H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000097:blood; D013205:Staphylococcal Protein A / Q000097:blood*
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D013205:Staphylococcal Protein A