Prediction of pre-eclampsia with maternal mid-trimester total renin, inhibin A, AFP and free beta-hCG levels

Prenat Diagn. 1999 Feb;19(2):122-7. doi: 10.1002/(sici)1097-0223(199902)19:2<122::aid-pd491>;2-r.


We wanted to study if maternal serum mid-trimester total renin, inhibin A, AFP or free beta-hCG levels predict the development of pre-eclampsia. Maternal serum alpha-fetoprotein (AFP) and human chorion gonadotrophin (beta-hCG) were evaluated in the screening programme for Down syndrome in 4356 patients prospectively. Data on pregnancy outcome were available in 1242 women. Pregnancy-induced hypertension (PIH) developed in 69 women, 282 women with uneventful pregnancy outcome were selected for controls. Serum total renin and inhibin A levels were measured retrospectively in the trisomy screening samples of 69 and 30 patients who later developed PIH, and in 282 and 7 patients, respectively, who had an uneventful pregnancy outcome. No significant differences were found in the levels of maternal mid-trimester serum total renin, inhibin A or free beta-hCG levels between PIH and healthy women. The multiples of the median (MoM) of AFP values were significantly higher in the subgroup of patients who later developed severe pre-eclampsia than in patients with mild pre-eclampsia or gestational hypertension and healthy pregnant women. Maternal mid-trimester serum levels of total renin, inhibin A and free beta-hCG are not predictive for development of PIH. High mid-trimester serum AFP values may help in the prediction of severe pre-eclampsia.

MeSH terms

  • Adult
  • Case-Control Studies
  • Chorionic Gonadotropin, beta Subunit, Human / blood*
  • Female
  • Humans
  • Inhibins / blood*
  • Pre-Eclampsia / blood
  • Pre-Eclampsia / diagnosis*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Trimester, Second
  • Prenatal Diagnosis* / methods
  • Prospective Studies
  • Renin / blood*
  • Retrospective Studies
  • Sensitivity and Specificity
  • alpha-Fetoproteins / metabolism*


  • Chorionic Gonadotropin, beta Subunit, Human
  • alpha-Fetoproteins
  • Inhibins
  • Renin