Elevated Second-Trimester Free β-hCG as an Isolated Finding and Pregnancy Outcomes

Abstract

Objective: To investigate the relationship between unexplained elevated second-trimester free β-human chorionic gonadotropin (β-hCG) levels and pregnancy complications as well as adverse pregnancy outcomes. Methods: The study cohort comprised 2,110 non-smoking women with chromosomal and structurally normal fetuses at low-risk for both Down’s syndrome (risk <1:250) and neural tube defects (maternal serum α-fetoprotein <2.0 MoM). A free β-hCG value of ≧2.0 MoM was used to define the populations with elevated levels of free β-hCG. Descriptive statistics, χ² test, Fisher’s exact test, and logistic regression analysis were used for statistical analysis, and p < 0.05 was considered statistically significant. Results: The mean maternal age of the study group was significantly lower than in controls (27.9 ± 4.3 and 30.6 ± 5.1 years, respectively, p < 0.05), while the proportion of primigravidas was significantly higher compared to that of controls (p < 0.05). After adjustment of the 2 groups according to maternal age and parity, we observed an increased incidence of preeclampsia among women with elevated free β-hCG levels in relation to controls (p < 0.05). However, a logistic regression analysis demonstrated that the free β-hCG level was not a predictor of the occurrence of preeclampsia. No significant relationship was found with the incidence of gestational diabetes, oligohydramnios, polyhydramnios, pregnancy-related hypertension, intrauterine growth retardation, preterm delivery, spontaneous abortion and stillbirths (p > 0.05).

The Effect of Serum β-Human Chorionic Gonadotropin on Pregnancy Complications and Adverse Pregnancy Outcomes: A Systematic Review and Meta-Analysis

“…However, the correlation of β-hCG and the incidence of pregnancy complications and adverse pregnancy outcomes have been controversial. Some studies suggested that high levels of β-hCG have no significant correlation with the incidence of IUGR, PIH, PD, and GDM [16]. In contrary, other studies concluded that high levels of β-hCG in the second trimester predict a high incidence of complications during pregnancy and poor pregnancy outcomes [17,18].…”

Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling

“…There were 23 primary articles, of which 19 evaluated the use of mid-trimester maternal serum hCG as a predictor of spontaneous preterm birth (n = 177,730 women) 157,158,162,165,166,[184][185][186][187][188][189][190][191][192][193][194][195][196][197] while one article evaluated it in early first trimester (n = 169), 198 and three articles evaluated cervicovaginal hCG as a predictor of spontaneous preterm birth in women who presented with symptoms of threatened preterm labour (n = 248). 139,199,200 Appendix 5, Table 85 summarises each study's salient features, stratified according to the population of women tested, i.e.…”

“…There were nine case-control studies in asymptomatic women 165,185,186,[189][190][191][192][193]195 and one in symptomatic women. 139 Four studies in asymptomatic women reported consecutive enrolments, 157,166,194,197 while none was reported in symptomatic women.…”

“…139 Four studies in asymptomatic women reported consecutive enrolments, 157,166,194,197 while none was reported in symptomatic women. There were 13 retrospective studies in asymptomatic women 158,165,[184][185][186][189][190][191][192][193]195,196,198 while all the studies in symptomatic women were prospective. None of the studies on asymptomatic women reported blinding and only one study in symptomatic women reported it.…”

Distribution of Biochemical and Ultrasound Markers Values in the First Trimester Screening Program in Timisoara

“…Free beta-hCG is a subunit of hCG a hormone produced by trophoblastic vili during pregnancy [11]. Elevated freebeta-hCG were found in pregnancies with fetuses with Down syndrome and preeclampsia [12].…”