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Second trimester maternal serum biomarkers and the risk of cerebral palsy
Author(s) -
Peris Monique,
Reid Susan M.,
Dobie Stephen,
Bonacquisto Leo,
Shepherd Daisy A.,
Amor David J.
Publication year - 2021
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.6011
Subject(s) - medicine , biomarker , cerebral palsy , confidence interval , pregnancy , population , obstetrics , estriol , case control study , gynecology , hormone , biology , biochemistry , genetics , environmental health , psychiatry
Aims To investigate whether second trimester maternal serum screening (2TMSS) biomarkers are associated with cerebral palsy (CP) and identify CP characteristics associated with abnormal biomarker levels. Method In this retrospective case–control data linkage study, we linked mothers of 129 singleton CP cases from a population register to their 2TMSS records and selected 10 singleton pregnancy controls per case ( n = 1290). We compared mean and abnormal levels of alpha‐fetoprotein (AFP), beta subunit of human chorionic gonadotrophin ( β ‐hCG), unconjugated estriol (uE3), and inhibin between cases and controls and within CP subgroups. Results Compared to control pregnancies, CP pregnancies had higher mean levels of AFP (1.10 vs. 1.01 multiple of the population median [MoM], p = 0.01) and inhibin (1.10 vs. 0.98 MoM, p ≤ 0.01). CP pregnancies were 2.5 times more likely to be associated with high levels of AFP (OR 2.52 [95% confidence interval [CI] 1.30, 4.65]; p < 0.01) and 2.6 times for inhibin (OR 2.63 [95% CI 1.37, 4.77]; p < 0.01), and 6.8 times when AFP and inhibin were both elevated (OR 6.75 [95% CI 2.41, 18.94]; p < 0.01). In CP cases, high AFP and high inhibin levels were associated with preterm birth and low birthweight. Interpretation Abnormal second‐trimester biomarker levels suggest abnormal placentation plays a role in the causal pathway of some CP cases.