Predicting complications of pregnancy with first-trimester maternal serum free-betahCG, PAPP-A and inhibin-A.
OBJECTIVE
To find whether fbetahCG, PAPP-A and inhibin-A levels in maternal serum or fetal nuchal translucency (NT) thickness at the first-trimester screening for trisomy 21 (T21) might detect women at high risk for adverse pregnancy outcomes.


METHODS
A retrospective analysis of 1136 women with singleton pregnancy between 10 and 14 weeks. Women with pregnancy complications were allotted to five subgroups: small for gestational age (SGA), large for gestational age (LGA), gestational diabetes (GDM), hypertensive disorders, preterm delivery; women with normal pregnancy represented the control group. NT, maternal serum fbetahCG, PAPP-A and inhibin-A were measured. Mann-Whitney test was used for the comparison of fbetahCG, PAPP-A, inhibin-A and NT between a subgroup of a certain pregnancy complication and the control group. Multivariate logistic regression models were built to explore the relationship among different variables and the occurrence of pregnancy complications.


RESULTS
PAPP-A values were significantly lower in women who delivered SGA babies (n=51, 0.76 MoM; p=0.002) and significantly higher in women who delivered LGA babies (n=120, 1.12 MoM; p=0.036). In women with GDM (n=27), fbetahCG, PAPP-A and inhibin-A were insignificantly lower than in controls, whereas in women with hypertensive disorders (n=56) no significant differences between the groups were found. In women with a preterm delivery (<34 weeks) (n=17), inhibin-A levels were significantly higher (1.25 MoM; p=0.015).


CONCLUSIONS
Low PAPP-A level is associated with the delivery of an SGA baby and high PAPP-A with the delivery of an LGA baby. High inhibin-A is associated with preterm delivery before 34 weeks. Feto-placental products in the first trimester do not prove to be useful as a screening tool for predicting pregnancy complications.
Tul
Natasa
N
Perinatology Unit, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slovenia. natasa.tul@guest.arnes.si
Pusenjak
Stanko
S
Osredkar
Josko
J
Spencer
Kevin
K
Novak-Antolic
Ziva
Z
D000293:Adolescent; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D004314:Down Syndrome / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005320:Fetal Macrosomia; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007265:Inhibins / Q000097:blood; D008499:Medical Records; D009333:Neck / Q000000981:diagnostic imaging / Q000196:embryology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism; D011296:Prenatal Diagnosis / Q000592:standards*; D012189:Retrospective Studies; D017524:Slovenia / Q000453:epidemiology; D014463:Ultrasonography
D018997:Chorionic Gonadotropin, beta Subunit, Human; C422362:inhibin A; D007265:Inhibins; D011266:Pregnancy-Associated Plasma Protein-A