title: Abnormal Biochemical Analytes Used for Aneuploidy Screening and Adverse Pregnancy Outcomes in Twin Gestations.
abstract: OBJECTIVE
  The objective of this study was to determine if first- and second-trimester biochemical markers for aneuploidy have an association with adverse pregnancy outcomes in twin gestations.
  
  
  METHODS
  A retrospective cohort study of patients who presented with dichorionic diamniotic twin gestations was performed. Patients with first-trimester low pregnancy-associated plasma protein A (PAPP-A) or low free β human chorionic gonadotropin (β-hCG), or second-trimester elevated α-fetoprotein (AFP), elevated inhibin A, elevated hCG, or low unconjugated estradiol were identified. The rates of adverse pregnancy outcomes were compared between patients with or without abnormal analytes with p < 0.05 used as significance.
  
  
  RESULTS
  In this study, 340 pregnancies were included. Patients with a low PAPP-A had an increased risk for delivery < 37 weeks. Patients with an elevated second-trimester hCG had an increased risk for spontaneous delivery < 28 weeks and neonatal intensive care unit (NICU) admission. Patients with an elevated inhibin A had an increased risk of spontaneous delivery at < 37 and NICU admission. Patients with an elevated AFP had an increased risk of a NICU admission.
  
  
  CONCLUSIONS
  Certain abnormal aneuploidy markers are associated with an increased risk of adverse pregnancy outcomes in twin gestations.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, New York, New York.
authors.forename: Jonathan Y
authors.initials: JY
authors.lastname: Rosner
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Fox
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Daniel
authors.initials: D
authors.lastname: Saltzman
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Chad K
authors.initials: CK
authors.lastname: Klauser
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Andrei
authors.initials: A
authors.lastname: Rebarber
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Simi
authors.initials: S
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000782:Aneuploidy; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood*; D015931:Intensive Care, Neonatal; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011262:Pregnancy Trimester, Second / Q000097:blood; D059285:Pregnancy, Twin; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D047928:Premature Birth / Q000097:blood; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins; C422362:inhibin A; D004958:Estradiol; D007265:Inhibins; D011266:Pregnancy-Associated Plasma Protein-A