Prediction of adverse pregnancy outcomes by extreme values of first trimester screening markers

Marina S Gomes; Mariana Carlos-Alves; Vera Trocado; Diana Arteiro; Paula Pinheiro

doi:10.1177/1753495X17704799

Prediction of adverse pregnancy outcomes by extreme values of first trimester screening markers

Obstet Med. 2017 Sep;10(3):132-137. doi: 10.1177/1753495X17704799. Epub 2017 May 16.

Authors

Marina S Gomes¹, Mariana Carlos-Alves¹, Vera Trocado^{1

2}, Diana Arteiro¹, Paula Pinheiro¹

Affiliations

¹ Department of Obstetrics and Gynecology, Alto Minho Local Healthcare Unit, Viana do Castelo, Portugal.
² School of Health Sciences, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.

Abstract

Background: To determine the association between extreme values of first trimester markers and adverse pregnancy outcomes.

Methods: A retrospective cohort study of 916 women who underwent first-trimester combined screening during 2015 was performed. Extreme values of NT, pregnancy-associated plasma protein-A (PAPP-A) and free β-hCG, and their association with adverse pregnancy outcomes were analyzed.

Results: Low PAPP-A (<10th percentile) was associated with an increased risk for preeclampsia (adjusted odds ratio (AOR) 4.13), fetal growth restriction (AOR 3.94) and abruptio placentae (AOR 52.63). Abnormally low or high free β-hCG, high PAPP-A or increased NT was not associated with an increased risk for adverse outcomes.

Discussion: PAPP-A <10th percentile could be associated with an increased risk for adverse outcomes. However, the majority of patients with these events do not have abnormal PAPP-A and few patients with PAPP-A <10th percentile will have an adverse outcome.

Keywords: Abruptio placentae; fetal growth; human chorionic-gonadotrophin beta-subunit; nuchal translucency; preeclampsia; pregnancy-associated plasma protein-A.