title: Decreased first-trimester maternal serum free-beta subunit human chorionic gonadotropin and preterm birth in twin gestations.
abstract: We investigated whether abnormal concentrations of first-trimester free-beta subunit human chorionic gonadotropin (fsshCG) and pregnancy-associated plasma protein A (PAPP-A) are associated with preterm delivery in twin gestations. This was a hospital-based, retrospective study of 70 twin gestations between 11 (1)/ (7) and 13 (6)/ (7) weeks' gestation undergoing first-trimester screening. Free betahCG and PAPP-A multiples of the median were determined by our laboratory standards. Odds ratios (ORs) were estimated that compared the prevalence of very preterm (< 32 weeks), preterm (> or = 32 and < 37 weeks), and term birth (> or = 37 weeks) between the lower and higher percentile groups for each analyte. FsshCG levels < or = 25th percentile were associated with very preterm birth < 32 weeks' gestation (OR 5.10; 95% confidence interval [CI]: 1.19 to 21.95), but not with preterm birth > or = 32 and < 37 weeks' gestation (OR 0.50; 95% CI: 0.16 to 1.61). PAPP-A was not associated with very preterm (OR 2.95; 95% CI: 0.69 to 12.60) or preterm birth (OR 0.71; 95% CI: 0.23 to 2.21). Low first-trimester fsshCG was a strong predictor for very preterm birth in twin gestations. Low first-trimester PAPP-A was associated with a trend in increased risk of very preterm birth.
authors.affiliation: University of Pittsburgh, Magee-Women's Hospital, Pennsylvania 15213, USA. slaughon@mail.magee.edu
authors.forename: S Katherine
authors.initials: SK
authors.lastname: Laughon
authors.forename: Andrei
authors.initials: A
authors.lastname: Rebarber
authors.forename: Linda
authors.initials: L
authors.lastname: Rolnitzky
authors.forename: Lois
authors.initials: L
authors.lastname: Fink
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Saltzman
mesh_terms: D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000097:blood*; D011272:Pregnancy, Multiple; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D047928:Premature Birth; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D014427:Twins
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A