Relationship between extreme values of first trimester maternal pregnancy associated plasma Protein-A, free-β-human chorionic gonadotropin, nuchal translucency and adverse pregnancy outcomes

Taiwan J Obstet Gynecol. 2022 May;61(3):433-440. doi: 10.1016/j.tjog.2022.02.043.

Abstract

Objective: The aim of our study was to investigate the relationship between extreme values of first trimester screening markers and adverse obstetric outcomes.

Materials and methods: Our study was conducted by examining the prenatal and postnatal perinatal records of 786 singleton gestations between the ages of 18-40, who applied to Prof. Dr. Cemil Taşçıoğlu City Hospital outpatient clinics for first-trimester screening for aneuploidy, between January 1, 2017 and December 31, 2019.

Results: The presence of small for gestational age (SGA) was found to be statistically significant for the <5 percentile (<0.37) pregnancy-associated plasma protein A (PAPP-A) group (p = 0.016). For <5 percentile β-hCG group, the presence of gestational diabetes mellitus (GDM), premature rupture of membrane (PROM) and preterm premature rupture of membrane (PPROM) was determined as a statistically significant risk (p = 0.015, p = 0.005, p = 0.02 respectively) In the univariate test, fetal death rate was found to be high for ≥90 percentile at nuchal translucency (NT), but the presence of fetal death was found to be statistically insignificant in logistic regression analysis. (p: 0.057).

Conclusion: First trimester screening test can be used in predicting pregnancy complications. In this study we found that serum levels of PAPP-A are associated with developing SGA, while GDM, PROM and PPROM are more common in low serum free β-hCG.

Keywords: Adverse pregnancy outcomes; First trimester; Free-β-human chorionic gonadotropin; Nuchal translucency; Pregnancy associated plasma protein-a.

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers
  • Chorionic Gonadotropin, beta Subunit, Human* / chemistry
  • Diabetes, Gestational*
  • Female
  • Fetal Death
  • Fetal Growth Retardation
  • Fetal Membranes, Premature Rupture
  • Humans
  • Infant, Newborn
  • Nuchal Translucency Measurement*
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Trimester, First
  • Pregnancy-Associated Plasma Protein-A* / chemistry
  • Prenatal Diagnosis
  • Young Adult

Substances

  • Biomarkers
  • Chorionic Gonadotropin, beta Subunit, Human
  • Pregnancy-Associated Plasma Protein-A

Supplementary concepts

  • Preterm Premature Rupture of the Membranes