title: Maternal serum free beta-hCG and PAPP-A in patients with habitual abortion-influence on first-trimester screening for chromosomal abnormalities.
abstract: OBJECTIVE
  To explore if maternal serum free beta-hCG and pregnancy-associated plasma protein A (PAPP-A) levels in the first-trimester of pregnancy are altered in patients with habitual abortions and if there is an effect on first-trimester screening for Down syndrome.
  
  
  METHODS
  A retrospective study was conducted on 913 normal singleton fetuses that underwent first-trimester combined screening for Down syndrome. Maternal serum PAPP-A and free beta-hCG were compared between patients with (n = 64) and without habitual abortions (n = 849).
  
  
  RESULTS
  The medians +/- SD log(10) MoM of PAPP-A and free beta-hCG +/- SD in patients with and without habitual abortions were 0.063 +/- 0.28 versus - 0.014 +/- 0.27 and - 0.001 +/- 0.27 versus - 0.018 +/- 0.31, with a p value of 0.042 and 0.87, respectively. The screen positive rate setting the cut off at 1:350 looking at the background risk for trisomy 21 was 71.4% in women with and 81.2% in women without habitual abortion, after combined first-trimester screening it was 7.8% in women with and 10.1% in women without recurrent abortion.
  
  
  CONCLUSIONS
  Patients with habitual abortions have slightly increased maternal serum PAPP-A levels in the first-trimester. This marginal difference seems not to effect risk calculation in combined first-trimester screening for trisomy 21.
authors.affiliation: Department of Obstetrics and Gynecology, University of Münster, Münster, Germany. heinig@uni-muenster.de
authors.forename: J
authors.initials: J
authors.lastname: Heinig
authors.forename: J
authors.initials: J
authors.lastname: Steinhard
authors.forename: R
authors.initials: R
authors.lastname: Schmitz
authors.forename: J-R
authors.initials: JR
authors.lastname: Nofer
authors.forename: L
authors.initials: L
authors.lastname: Kiesel
authors.forename: W
authors.initials: W
authors.lastname: Klockenbusch
mesh_terms: D000026:Abortion, Habitual / Q000097:blood*; D000293:Adolescent; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D002869:Chromosome Aberrations; D002891:Chromosomes, Human, Pair 21; D004314:Down Syndrome / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005820:Genetic Testing; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011296:Prenatal Diagnosis / Q000379:methods; D012307:Risk Factors
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A