Association between fetal nuchal translucency thickness in first trimester and subsequent gestational hypertension and preeclampsia.
Increased fetal nuchal translucency (NT) in the first trimester is associated with adverse pregnancy outcomes. Whether the increased NT is also associated with an increased frequency of pregnancy-associated hypertension (PAH) is not known. Seven hundred and seventy-nine pregnant women who received NT-based Down syndrome screening and delivered their babies at our hospital by September 2000 were enrolled into this study. Among these women, there are 46 cases of preeclampsia, 68 cases of gestational hypertension (GH); 665 women without any adverse pregnancy outcomes served as controls. Correlation analysis demonstrated that NT MoM (multiples of median) level had a positive association with maternal diastolic blood pressure at the time of admission for delivery (r = 0.104; p < 0.01). The severity of PAH was concordant with the stepwise increase of mean NT MoM level, which was 0.88 in control, 1.07 in gestational hypertension, and 1.13 in preeclampsia (p < 0.001). Using the 95th (1.52 MoM) and 90th (1.31 MoM) percentiles of NT thickness as cut-offs, the sensitivities and odds ratios of the women at risk for developing GH after 20 weeks of gestation were 8.8%, 19.1% and 1.98, 2.15 respectively, while for preeclampsia were 10.9%, 28.3% and 2.49, 3.58 respectively. It is concluded that the pathological changes in the placenta responsible for the development of PAH may also influence the physiological decrease of NT thickness in late first trimester. However, the sensitivity of fetal NT measurement in first trimester is not sufficient as a single marker for predicting the pregnant women at risk for subsequent PAH.
Tsai
Ming-Song
MS
Prenatal Diagnosis Center, Cathay General Hospital, Taipei, Taiwan. mstsai@ms1.cgh.org.tw
Lee
Fa-Kung
FK
Cheng
Chih-Chien
CC
Hwa
Kuo-Yuan
KY
Cheong
Mei-Leng
ML
She
Bo-Quing
BQ
D000328:Adult; D001794:Blood Pressure; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000032:analysis; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000209:etiology*; D008423:Maternal Age; D009333:Neck / Q000000981:diagnostic imaging* / Q000196:embryology*; D011225:Pre-Eclampsia / Q000097:blood / Q000209:etiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D018566:Pregnancy, High-Risk; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D016216:Ultrasonography, Prenatal
D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A