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First trimester maternal serum free β human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complications
Author(s) -
Ong Charas Y. T.,
Liao Adolfo W.,
Spencer Kevin,
Munim Shama,
Nicolaides Kypros H.
Publication year - 2000
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2000.tb11618.x
Subject(s) - pregnancy , medicine , miscarriage , obstetrics , gestation , pregnancy associated plasma protein a , gestational diabetes , gynecology , first trimester , biology , genetics
Objective To examine the value of first trimester maternal serum free β human chorionic gonadotrophin (β hCG) and pregnancy associated plasma protein A (PAPP‐A) as predictors of pregnancy complications. Design Screening study. Setting Antenatal clinics. Population Singleton pregnancies at 10–14 weeks of gestation. Methods Maternal serum free β hCG and PAPP‐A were measured at 10–14 weeks of gestation in 5584 singleton pregnancies. In the 5297 (94.9%) pregnancies with complete follow up free β hCG and PAPP‐A were compared between those with normal outcome and those resulting in miscarriage, spontaneous preterm delivery, pregnancy induced hypertension or fetal growth restriction and in those with pre‐existing or gestational diabetes. Results Maternal serum PAPP‐A increased and β hCG decreased with gestation. The multiple of median maternal serum PAPP‐A was significantly lower in those pregnancies resulting in miscarriage, pregnancy induced hypertension, growth restriction and in those with pre‐existing or gestational diabetes mellitus, but not in those complicated by spontaneous preterm delivery. The level was < 10th centile of the reference range in about 20% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 27% of those that developed gestational diabetes. Maternal serum free β hCG was < 10th centile of the reference range in about 15% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 20% of those that developed gestational diabetes. Conclusion Low maternal serum PAPP‐A or β hCG at 10–14 weeks of gestation are associated with subsequent development of pregnancy complications.