A cohort study of the association between maternal serum Inhibin-A and adverse pregnancy outcomes: a population-based study

Abstract

Background To compare the rates of adverse pregnancy outcomes between women with normal and abnormal inhibin-A levels. Methods Based on a prospective database of Down syndrome screening program, the consecutive records were comprehensively reviewed. Pregnancies were classified into three groups: normal, high (> 2 MoM) and low (< 0.5 MoM) inhibin-A levels. The pregnancies with medical diseases, chromosome abnormalities and fetal anomalies were excluded. The primary outcomes were the rates of preterm birth, preeclampsia, and fetal growth restriction (FGR). Results Of 6679 recruited pregnancies, 5080 met the inclusion criteria, including 4600, 205 and 275 pregnancies in the group of normal, high, and low inhibin-A levels respectively. The rates of preterm birth, preeclampsia and FGR were significantly higher in the group of high levels; (RR, 1.51, 95%CI: 1.01–2.26; 3.47, 95% CI: 2.13–5.65; 3.04, 95% CI: 1.99–4.65 respectively), whereas the rates of other adverse outcomes were comparable. However, the rate of spontaneous preterm birth among women with high inhibin-A was not significantly increased. Based on multivariate analysis, the preterm birth rate was not significantly associated with inhibin-A levels, but it was rather a consequence of preeclampsia and FGR. Low levels of serum inhibin-A were not significantly associated with any adverse outcomes. Conclusions High levels of maternal serum inhibin-A in the second trimester are significantly associated with abnormal placentation, which increases the risk of preeclampsia and FGR with a consequence of indicated preterm birth but not a risk of spontaneous preterm birth. In contrast, low inhibin-A levels were not associated with any common adverse pregnancy outcomes.

Second trimester maternal serum biomarkers and the risk of cerebral palsy

“…Singnoi et al. noted an association between high second trimester inhibin levels and adverse outcomes such as pre‐eclampsia and fetal growth restriction, with no reported association with preterm birth 45 . In contrast, Yue et al.…”

A Propose of Effective Model For Prediction of Spontaneous Preterm Delivery With Quadruple Serum Biomarkers of Aneuploidy Screening.

“…In Thailand, the quadruple test, offered by the National Health Policy free of charge, has been used for many years as a universal screening method for Down syndrome. Many studies have reported the extra bene t of the serum quadruple test as a predictor of adverse pregnancy outcomes, including preterm delivery [20,21,24,25,29,36,38]. However, the results of the serum quadruple test vary for the cutoff of each serum biomarker and it has to date shown limited use in predicting sPTD [20,21,24,25,29,36].…”

“…Many studies have showed associations between abnormal serum biomarkers and adverse pregnancy outcomes, especially preterm outcomes in euploid fetuses [21,23,32,36,37]. High levels of AFP, β-hCG, and inhibin A with a low level of UE3 have been shown to be associated with adverse pregnancy outcomes, especially in preterm births [20,21,24,25,29,31,32,[36][37][38]. Many studies have attempted to elaborate the relationship between serum biomarkers and adverse pregnancy outcomes, particularly sPTD.…”

“…Many studies have attempted to elaborate the relationship between serum biomarkers and adverse pregnancy outcomes, particularly sPTD. However, there have been some con icting ndings regarding the protocol or cutoff levels of these serum biomarkers among these studies [20,21,24,25,38]. Our study aimed to examine the associations between the biomarkers assessed in the serum quadruple test and the prediction of sPTD as a further screening model as an adjunctive bene t of Down syndrome screening.…”

False-Positive Maternal Serum Screens in the Second Trimester as Markers of Placentally Mediated Complications Later in Pregnancy: A Systematic Review and Meta-Analysis

“…High levels of hCG have been attributed to hypoxic placental cells and related pregnancy complications [11][12][13][14]. Fetal loss, growth restriction, hypertensive disorders of pregnancy, preterm birth, oligohydramnios, and abruption have all been described in the context of abnormal AFP, hCG, uE3, and DIA levels in pregnancy [10][11][12][13][14][15][16][17][18][19][20]. However, there remains no clear guidance in the literature about the exact magnitude of risk or about how such pregnancies with false-positive MSS results should be managed [6].…”