title: The association of triple-marker test results with adverse pregnancy outcomes in low-risk pregnancies with healthy newborns.
abstract: OBJECTIVE
  This study was designed to investigate the relationship between the second trimester maternal serum markers and adverse pregnancy outcomes in healthy newborns.
  
  
  METHODS
  A total of 749 women who delivered in our institution with complete follow up and second-trimester triple marker test data available were included in the study. Women with multiple pregnancies, chronic diseases, diabetes mellitus, obesity, smokers and infants with chromosomal and congenital abnormalities were excluded. Maternal serum alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and unconjugated estriol (uE(3)) values were investigated in our cohort who developed preeclampsia (n = 28), gestational diabetes (GM) (n = 69), preterm labor-birth (n = 100), oligohydramnios (n = 37) and macrosomia (n = 59) by using receiver operating characteristic (ROC) curve analysis, with chi-square and Pearson's correlation tests.
  
  
  RESULTS
  Women with uE(3) < or = 1.26 MoM (P = 0.001, AUC = 0.666), HCG > 1.04 MoM (P = 0.032, AUC = 0.599) or AFP < or = 0.69 MoM (P = 0.049, AUC = 0.600) values significantly developed oligohydramnios. Also, macrosomic infants were observed in women who had HCG values > 0.86 MoM (P = 0.047, AUC = 0.578). Patients with HCG > 1.04 MoM (P = 0.04, AUC = 0.565) and uE(3) < or =0.88 MoM (P = 0.049, AUC = 0.571) developed GDM. HCG levels > or =2.5 or > or =3 MoM were significantly associated with the development of oligohydramnios [P = 0.005; OR = 4 (95% CI: 1.7-9.7)], [P = 0.008; OR = 4.9 (95% CI: 1.7-13.7)], respectively. When women with adverse (n = 237) and normal (n = 512) outcomes were compared there were significant differences in maternal serum AFP (1.40 +/- 0.84 vs. 1.23 +/- 0.75 MoM, P = 0.006) and uE(3) values (1.38 +/- 1.42 vs. 1.45 +/- 0.98 MoM, P = 0.001).
  
  
  CONCLUSIONS
  Serum estriol, AFP or HCG values in triple test results may be associated with development of oligohydramnios, gestational diabetes and macrosomia in women with healthy and normal appearing fetuses.
authors.affiliation: Department of Obstetrics and Gynecology, Trakya University, Edirne, Turkey. ncsayin@yahoo.com
authors.forename: N Cenk
authors.initials: NC
authors.lastname: Sayin
authors.forename: M Tunç
authors.initials: MT
authors.lastname: Canda
authors.forename: Nefize
authors.initials: N
authors.lastname: Ahmet
authors.forename: Sezer
authors.initials: S
authors.lastname: Arda
authors.forename: Necdet
authors.initials: N
authors.lastname: Süt
authors.forename: Füsun G
authors.initials: FG
authors.lastname: Varol
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D001835:Body Weight; D002508:Cephalometry; D006063:Chorionic Gonadotropin / Q000097:blood*; D004964:Estriol / Q000097:blood*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins; D004964:Estriol