Is maternal renal disease a cause of elevated free beta-hCG in first trimester aneuploidy screening?
OBJECTIVE
To asses whether supra elevated levels of maternal serum free beta hCG in the first trimester are associated with impaired renal function.


METHODS
A cohort of 553 women with maternal serum free beta-hCG greater than 5 multiple of median (MoM) with a single euploid fetus was matched with a control of the same maternal age (+/-1 year), ethnic origin and with a free beta-hCG within the range 0.50-1.50 MoM. Screening samples were analysed for serum creatinine and estimated glomerular filtration rate was calculated. Renal function in the two groups was compared. The database was examined to find outcomes registered as known renal disease amongst the high free beta-hCG group.


RESULTS
In the group with a supra elevated free beta-hCG MoM there was a significant reduction in estimated glomerular filtration rate (eGFR) (122.85, 95% CI 120.43-124.74 vs 118.80, 95% CI 114.90-121.59; p = 0.009) suggesting a small but increased risk of renal disease.


CONCLUSIONS
The presence of renal disease should also be considered as one potential cause of supra elevated levels of free beta-hCG in addition to the possibility of paternally derived triploidy and trisomy 21.
Spencer
Kevin
K
Clinical Biochemistry Department, King George Hospital, Barley Lane, Goodmayes IG3 8YB, UK. KevinSpencer1@aol.com
Enofe
Osasumwen
O
Cowans
Nicholas J
NJ
Stamatopoulou
Anastasia
A
D000328:Adult; D000782:Aneuploidy; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D003937:Diagnosis, Differential; D004314:Down Syndrome / Q000175:diagnosis; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D009035:Mothers; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000175:diagnosis*; D011261:Pregnancy Trimester, First / Q000097:blood*; D011296:Prenatal Diagnosis / Q000379:methods / Q000592:standards; D015854:Up-Regulation; D055815:Young Adult
D018997:Chorionic Gonadotropin, beta Subunit, Human