The Values of First-trimester Maternal Serum Markers in Predicting Poor Obstetric Outcomes

Abstract

Introduction:The effects of pregnancy-associated plasma protein A (PAPP-A) and maternal serum free beta-human chorionic gonadotropin (β-hCG), which are first trimester maternal serum markers, on assisting in the diagnosis of chromosomal abnormalities and perinatal outcome are discussed. The aim of the presented study was to investigate the predictive value of first-trimester PAPP-A and β-hCG) levels in predicting poor obstetric outcomes.Methods:A total of 549 patients who underwent first trimester screening in Perinatalogy Outpatient Clinic of our hospital between January 2016 and March 2018 were included in this study. Patients with crown-rump length (CRL) measurements in the range of 45-84 mm, patients with singleton pregnancy and patients who delivered at 24 weeks or later were included in the study. CRL, nuchal translucency, mean uterine artery pulsatility index, PAPP-A and free β-hCG levels were recorded. The 5th and 10th percentile values of PAPP-A and free β-hCG levels were designated according to the literature.Results:There was no difference between PAPP-A percentile groups in terms of mean birth weight or gestational age at delivery. However, mean gestational age at delivery was lower in patients with free β-hCG levels below 10th percentile. Preterm delivery was significantly higher in the group with PAPP-A levels below 5th percentile (p=0.049). Also, preeclampsia (PE) was higher in the group with free β-hCG below 10th percentile (p=0.003).Conclusion:The risk poor obstetric outcome such as preterm delivery, low birth weight and PE may be associated with low PAPP-A and free β-hCG levels. However, further studies are needed to explain the relationship between first trimester screening markers and neonatal outcomes.

Keywords

• Pregnancy-associated plasma protein A
• beta HCG
• preeclampsia
• preterm delivery