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Second trimester serum predictors of congenital heart defects in pregnancies without chromosomal or neural tube defects
Author(s) -
JelliffePawlowski Laura,
Baer Rebecca,
MoonGrady Anita J.,
Currier Robert J.
Publication year - 2011
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.2720
Subject(s) - medicine , odds ratio , percentile , neural tube , estriol , confidence interval , logistic regression , alpha fetoprotein , obstetrics , neural tube defect , pregnancy , trisomy , aneuploidy , second trimester , biomarker , down syndrome , gynecology , fetus , hormone , biology , chromosome , embryo , statistics , genetics , biochemistry , mathematics , psychiatry , hepatocellular carcinoma , gene , microbiology and biotechnology
Objective To compare euploid pregnancies with congenital heart defects (CHDs) to similar pregnancies without CHDs on typically collected second trimester biomarker measurements. Method Second trimester serum levels of alpha‐fetoprotein (AFP), human chorionic gonadotrophin (hCG), and unconjugated estriol were compared for 306 CHD cases and 1224 no‐CHD controls drawn from a sample of singleton pregnancies without chromosomal or neural tube defects (NTDs). Logistic regression models were built comparing biomarkers for cases and controls. Results Regardless of the severity of defect, CHD cases were more likely to have unusually high AFP and/or hCG levels and/or unusually low hCG and/or uE3 levels [odds ratio (OR) 1.8–2.4, 95% confidence intervals (CIs) 1.2–4.0]. Cases with critical CHDs were more than twice as likely to have an AFP multiple of the median (MoM) ≥ the 95th percentile and/or an hCG and/uE3 MoM ≤ the 5th percentile (OR 2.1–3.9, 95% CIs 1.1–7.8). Conclusion Abnormal levels of specific second trimester maternal serum biomarkers indicated an increased risk for CHDs among this sample of low risk pregnancies. Our data suggest that future efforts aimed at improving CHD detection in low risk pregnancies may benefit from considering serum biomarkers. Copyright © 2011 John Wiley & Sons, Ltd.