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Unexplained elevated maternal serum β‐HCG concentration and adverse pregnancy outcome
Author(s) -
Ganapathy Ramesh,
Lamont Ronald F.,
Bassett Paul
Publication year - 2007
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.1813
Subject(s) - medicine , pregnancy , obstetrics , confidence interval , gestational age , small for gestational age , gynecology , biology , genetics
Objective To investigate the association between unexplained elevated maternal serum β‐Human chorionic gonadotrophin (HCG) in the second trimester of pregnancy and adverse pregnancy outcome. Methods In a case‐controlled study of 3463 women who opted for second‐trimester serum screening for Down syndrome, 142 were found to have a serum β‐HCG of ≥3.5 multiples of the median (MoM), 56 of whom had a serum β‐HCG of ≥5.0 MoM. These women were compared with a control group of women with serum β‐HCG within the 95% confidence interval around the median. Results In the elevated β‐HCG group (≥5 MoM) significantly more babies required admission to the special care baby unit ( p = 0.02) and were small for gestational age (SGA) ( p = 0.03). The mean birth weight was also significantly lower in the group with elevated β‐HCG. Women with a serum β‐HCG of ≥5, ≥6, ≥7 or ≥8 MoM were associated with SGA babies in 40, 44, 64 and 86% respectively. All babies born to the six women with β‐HCG of 8.75–24.1 MoM were SGA. Conclusion Increased surveillance is necessary in pregnancies where the maternal serum β‐HCG in the second trimester is inexplicably elevated to ≥5 MoM. Copyright © 2007 John Wiley & Sons, Ltd.