The efficiency of first-trimester serum analytes and maternal characteristics in predicting fetal growth disorders.
OBJECTIVE
To evaluate the association between first-trimester serum analytes, pregnancy-associated plasma protein A and free beta-human chorionic gonadotropin, and fetal growth disorders, and to determine whether a prediction model for these growth disorders can be developed.


METHODS
Retrospective cohort study of patients seen for first-trimester aneuploidy screening. Pregnancy-associated plasma protein A and free beta-human chorionic gonadotropin multiples of the median were evaluated for association with small- and large-for-gestational-age infants in combination with maternal characteristics. Univariate and backward stepwise logistic regression analyses were performed and the area under the receiver-operator curves used to determine the best prediction models.


RESULTS
Neither pregnancy-associated plasma protein A nor free beta-human chorionic gonadotropin levels were associated with an increased risk of large-for-gestational-age infants. For small-for-gestational-age infants, the final model included black race, free beta-human chorionic gonadotropin multiples of the median >90th percentile, and pregnancy-associated plasma protein A multiples of the median <5th percentile as significant predictors (area under the curve = 0.58).


CONCLUSIONS
Low pregnancy-associated plasma protein A and high free beta-human chorionic gonadotropin levels are associated with a small-for-gestational-age growth pattern; however, additional factors to improve the prediction model are needed.
Goetzinger
Katherine R
KR
Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA.
Singla
Ashima
A
Gerkowicz
Sabrina
S
Dicke
Jeffrey M
JM
Gray
Diana L
DL
Odibo
Anthony O
AO
D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D005320:Fetal Macrosomia / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012372:ROC Curve; D012189:Retrospective Studies
D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A