title: Associations between maternal serum free beta human chorionic gonadotropin (β-hCG) levels and adverse pregnancy outcomes.
abstract: The objective was to determine the strength of relationship between maternal free beta human chorionic gonadotropin (β-hCG) concentrations and rates of adverse pregnancy outcomes. Consecutive records of the database of our Down screening project were assessed for free β-hCG levels and pregnancy outcomes. Pregnancies with foetal chromosomal or structural anomalies and those with underlying disease were excluded. Free β-hCG levels of < 0.5, > 0.5 and < 2.0, and ≥ 2.0 MoM were categorised as low, normal and high, respectively. Of 17,082 screened women, 13,620 were available for analysis. In the first trimester (n = 8150), low β-hCG levels significantly increased risk for intrauterine growth restriction (IUGR), preterm birth, low birth weight (LBW) and low Apgar score with relative risk of 1.66, 1.43, 1.83 and 2.89; whereas high β-hCG group had a significant decreased risk of preterm birth and GDM with relative risk of 0.73 and 0.62. In the second trimester (n = 5470), both low and high β-hCG groups had significant increased risks of the most common adverse outcomes, i.e. spontaneous abortion, IUGR and preterm birth. In conclusion, abnormally low (< 0.5MoM) or high (> 2.0 MoM) free β-hCG levels are generally associated with an increased risk of adverse pregnancy outcomes. Nevertheless, high free β-hCG levels in the first trimester may possibly decrease risk of preterm delivery and GDM.
authors.affiliation: a Department of Obstetrics and Gynecology , Chiang Mai University , Chiang Mai , Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Sirikunalai
authors.affiliation: a Department of Obstetrics and Gynecology , Chiang Mai University , Chiang Mai , Thailand.
authors.forename: C
authors.initials: C
authors.lastname: Wanapirak
authors.affiliation: a Department of Obstetrics and Gynecology , Chiang Mai University , Chiang Mai , Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Sirichotiyakul
authors.affiliation: a Department of Obstetrics and Gynecology , Chiang Mai University , Chiang Mai , Thailand.
authors.forename: F
authors.initials: F
authors.lastname: Tongprasert
authors.affiliation: a Department of Obstetrics and Gynecology , Chiang Mai University , Chiang Mai , Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Srisupundit
authors.affiliation: a Department of Obstetrics and Gynecology , Chiang Mai University , Chiang Mai , Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Luewan
authors.affiliation: a Department of Obstetrics and Gynecology , Chiang Mai University , Chiang Mai , Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Traisrisilp
authors.affiliation: a Department of Obstetrics and Gynecology , Chiang Mai University , Chiang Mai , Thailand.
authors.forename: T
authors.initials: T
authors.lastname: Tongsong
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D001034:Apgar Score; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D016640:Diabetes, Gestational / Q000453:epidemiology; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D006801:Humans; D007230:Infant, Low Birth Weight; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011264:Pregnancy Trimesters / Q000097:blood; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human
keywords: adverse pregnancy outcomes; first trimester screening; maternal serum marker; second trimester screening; β-hCG