☆ 4.6 Article

Serum free β-human chorionic gonadotropin in the three trimesters of pregnancy: effects of maternal characteristics and medical history

ULTRASOUND IN OBSTETRICS & GYNECOLOGY (2015)

Journal

ULTRASOUND IN OBSTETRICS & GYNECOLOGY

Volume 46, Issue 1, Pages 51-59

Publisher

WILEY

DOI: 10.1002/uog.14869

Keywords

first-trimester screening; human chorionic gonadotropin; pre-eclampsia; pyramid of pregnancy care; second-trimester screening; third-trimester screening; trisomy 18; trisomy 21

Funding

Fetal Medicine Foundation [1037116]
European Union [601852]

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Abstract

Objective To define the contribution of maternal variables which influence the measured level of maternal serum free beta-human chorionic gonadotropin (beta-hCG) in screening for pregnancy complications. Methods Maternal characteristics and medical history were recorded and serum free beta-hCG was measured in women with a singleton pregnancy attending for three routine hospital visits at 11+0 to 13+6, 19+0 to 24+6 and 30+0 to 34+6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths >= 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of free beta-hCG were determined from a linear mixed-effects multiple regression. Results Serum free beta-hCG was measured in 94 985 cases in the first trimester, 7879 in the second trimester and 8424 in the third trimester. Significant independent contributions to serum free beta-hCG were provided by gestational age, maternal weight, age and racial origin, cigarette smoking, method of conception, diabetes mellitus and family history of pre-eclampsia (PE) in the mother of the patient. The effects of some variables were similar and those for others differed in each trimester. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum free beta-hCG and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates both in pregnancies that developed PE and in those without this pregnancy complication. Conclusions A model was fitted to express measured serum free beta-hCG across the three trimesters of pregnancy as MoMs after adjusting for variables from maternal characteristics and medical history that affect this measurement. Copyright (C) 2015 ISUOG. Published by John Wiley & Sons Ltd.

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Extreme beta HCG levels in first trimester screening are risk factors for adverse maternal and fetal outcomes

Sarang Younesi, Laleh Eslamian, Nikta Khalafi, Mohammad Mahdi Taheri Amin, Pourandokht Saadati, Soudabeh Jamali, Payam Balvayeh, Mohammad-Hossein Modarressi, Shahram Savad, Saloomeh Amidi, Saeed Delshad, Fariba Navidpour, Bahareh Yazdani, Fatemeh Aasdi, Samira Chagheri, Yalda Mohammadi, Vajiheh Marsoosi, Ashraf Jamal, Soudeh Ghafouri-Fard

Summary: Multiples of the normal median (MoM) of free beta HCG is a valuable parameter in evaluating risk of adverse pregnancy outcomes. This retrospective study examined the maternal and fetal outcomes of pregnant women with MoM levels of free beta HCG < 0.2 or > 5 in their first trimester screening. The study found that high MoM levels were associated with an increased risk of trisomy 21, while low MoM levels were associated with a higher risk of trisomies 13 and 18 and Turner syndrome. Other chromosomal abnormalities were equally detected in both groups. There was also an increased risk of certain complications such as hydrocephaly, hydrops fetalis, low birth weight, gestational diabetes mellitus, preeclampsia, preterm delivery, and vaginal bleeding with higher MoM levels.

SCIENTIFIC REPORTS (2023)