Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: a population-based study

Boonpiam, Rakchanok; Wanapirak, Chanane; Sirichotiyakul, Supatra; Sekararithi, Ratanaporn; Traisrisilp, Kuntharee; Tongsong, Theera

doi:10.1186/s12884-020-03298-9

Cited by 15 publications

(14 citation statements)

References 23 publications

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“…In previous reports, high hCG in maternal blood has been observed from early pregnancy in patients with FGR and PE 9 – 11 . Therefore, we first investigated whether hCG was also elevated in the postnatal placentas of these patients.…”

Section: Resultsmentioning

confidence: 83%

“…hCG is produced by syncytiotrophoblasts (STB) and peaks between the 7th and 10th weeks of pregnancy, with a nadir at 18th weeks 8 . Several studies have demonstrated that patients with FGR and PE exhibit higher blood levels of hCG from early pregnancy until before delivery 9 – 11 , and placental dysfunction may reflect the increased hCG levels 12 – 15 . Therefore, we speculated that high hCG is a risk factor for the development of FGR and PE.…”

Section: Introductionmentioning

confidence: 99%

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Mitochondrial dysfunction-induced high hCG associated with development of fetal growth restriction and pre-eclampsia with fetal growth restriction

Kiyokoba

Uchiumi

Yagi

et al. 2022

Sci Rep

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Fetal growth restriction (FGR) and pre-eclampsia with fetal growth restriction (PE/FGR) are high-risk perinatal diseases that may involve high levels of human chorionic gonadotropin (hCG) and mitochondrial dysfunction. However, little is known about how these factors affect placental function. We investigated how mitochondrial dysfunction and high hCG expression affected placental function in unexplained FGR and PE/FGR. We observed elevated expression of hCGβ and growth differentiation factor 15 mRNA and protein levels in the placenta with both diseases. Likewise, antiangiogenic factors, such as Ang2, IP10, sFlt1, IL8, IL1B, and TNFα, were also upregulated at the mRNA level. In addition, the expression of COXI and COXII which encoded by mitochondrial DNA were significantly decreased in both diseases, suggesting that mitochondrial translation was impaired. Treatment with hCG increased Ang2, IP10, IL8, and TNFα mRNA levels in a dose-dependent manner via the p38 and JNK pathways. Mitochondrial translation inhibitors increased hCGβ expression through stabilization of HIF1α, and increased IL8 and TNFα mRNA expression. These results revealed that high expression of hCG due to mitochondrial translational dysfunction plays an important role in the pathogenesis of FGR and PE/FGR.

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Section: Resultsmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Mitochondrial dysfunction-induced high hCG associated with development of fetal growth restriction and pre-eclampsia with fetal growth restriction

Kiyokoba

Uchiumi

Yagi

et al. 2022

Sci Rep

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“…AFP is then transported to maternal serum through the placenta or by diffusion across fetal membranes [15,16]. Elevated msAFP values are found to be associated with the fetalmaternal-placental barrier disruption, placental vascular damage or bleeding, or feto-placental ischemia and can compromise the development of a structurally normal fetus [16,17]. The relationship between the AFP increase in the second trimester and pregnancy complications (such as gestational hypertension, preeclampsia, fetal loss, preterm delivery, IUGR, placental abruption, and bleeding) has also been established [14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…Elevated msAFP values are found to be associated with the fetal-maternal-placental barrier disruption, placental vascular damage or bleeding, or feto-placental ischemia and can compromise the development of a structurally normal fetus [ 16 , 17 ]. The relationship between the AFP increase in the second trimester and pregnancy complications (such as gestational hypertension, preeclampsia, fetal loss, preterm delivery, IUGR, placental abruption, and bleeding) has also been established [ 14 - 17 ]. Therefore, the link between AFP increase and IUGR yielded by our analyses is supported by empirical evidence [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction of Pregnancy Complications With Maternal Biochemical Markers Used in Down Syndrome Screening

Özdemir¹,

Şahin²,

Acar³

et al. 2022

Cureus

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Objective: To determine whether first-and second-trimester maternal serum biomarkers are useful for the prediction of pregnancy complications like preterm birth, intrauterine growth restriction (IUGR), and macrosomia.Methods: We conducted a retrospective analysis of 353 women having first-or second-trimester combined test for Down syndrome screening who delivered at our institution between January 2018 and December 2020. Associations between first-and second-trimester serum markers and adverse pregnancy outcomes among those who underwent prenatal screening for Down syndrome in our clinic were studied. The adverse pregnancy outcomes, serum levels of pregnancy-associated plasma protein-A (PAPP-A), β-human chorionic gonadotropin (β-hCG), and maternal serum alpha-fetoprotein (ms-AFP) were recorded and analyzed. Correlation analyses of PAPP-A, free βhCG, and ms-AFP with pregnancy outcomes were studied. We sought to predict the risks of preterm delivery (PTD, <37 weeks gestational age), low birth weight (LBW, <2500 grams) and macrosomia (>4000 grams).Results: A total of 353 women who had first-and second-trimester screening test for Down syndrome were included. Two hundred fifty (70.08%) of them had first-trimester and 103 (41.2%) had second-trimester test. Mean age of the patients who underwent screening test for Down syndrome was 29.3±5.9, mean maternal weight was 67.3±13.6, mean gestational weeks at birth was 38.6±2.1 weeks and mean birth weight was 3260.9±511.1, preterm birth rate was 40/353 (11.3%), IUGR rate was 21/353 (5.9%), macrosomia rate was 17/353 (4.8%), stillbirth rate was 3/353 (0.8%). When laboratory and clinical parameters affecting birth weight and birth weeks were analysed in correlation analysis, both birth week and birth weight were found to be positively correlated with maternal weight. Of first-trimester markers Papp-A MoM (Multiples of Median) was found to be positively correlated with fetal birth weight (p = 0.044). Of second-trimester biochemical parameters ms-AFP was found to be negatively correlated with fetal birth weight (p = 0.039). Conclusion:The study concluded that there is a relationship between serum markers and adverse pregnancy outcomes. Significant associations were found between the levels of first-and second-trimester serum markers PAPP-A, AFP and IUGR, macromia and additionally significant association was found between maternal weight and both delivery week and fetal weight. These results can highlight the pregnancies at risk and follow-up intervals may be arranged according to risk scala which may help at antenatal follow-up of high-risk patients.

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“…Combination of the clinical, biochemical, and biophysical markers is likely to increase the predictive power of screening examinations [ 36 ]. Currently, the implementation of serum biomarker screening quad test (AFP, alpha-fetoprotein; BHCG, beta-human gonadotropin; uE3, unconjugated estriol; and IHA, inhibin-A) for fetal aneuploidy has commenced worldwide, and many studies have shown that additional information derived from such screenings, other than aneuploidy risk estimation, can also be used to identify the risk of adverse obstetric outcomes, such as fetal growth restriction, PE, and preterm birth [ 37 , 38 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Selenium Supplementation on Clinical Outcomes, Metabolic Profiles, and Pulsatility Index of the Uterine Artery in High-Risk Mothers in Terms of Preeclampsia Screening with Quadruple Test: a Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Mesdaghinia

Shahin

Ghaderi

et al. 2022

Biol Trace Elem Res

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Data on the effects of selenium (Se) supplementation on clinical outcomes, metabolic profiles, and pulsatility index (PI) in high-risk mothers in terms of preeclampsia (PE) screening with quadruple tests are scarce. This study evaluated the effects of Se supplementation on clinical outcomes, metabolic profiles, and uterine artery PI on Doppler ultrasound in high-risk mothers in terms of PE screening with quad marker. The current randomized, double-blind, placebo-controlled trial was conducted among 60 high-risk pregnant women screening for PE with quad tests. Participants were randomly allocated into two groups (30 participants each group), received either 200 µg/day Se supplements (as Se amino acid chelate) or placebo from 16 to 18 weeks of pregnancy for 12 weeks. Clinical outcomes, metabolic profiles, and uterine artery PI were assessed at baseline and at the end of trial. Se supplementation resulted in a significant elevation in serum Se levels (β 22.25 µg/dl; 95% CI, 18.3, 26.1; P < 0.001) compared with the placebo. Also, Se supplementation resulted in a significant elevation in total antioxidant capacity (β 82.88 mmol/L; 95% CI, 3.03, 162.73; P = 0.04), and total glutathione (β 71.35 µmol/L; 95% CI, 5.76, 136.94; P = 0.03), and a significant reduction in high-sensitivity C-reactive protein levels (β − 1.52; 95% CI, − 2.91, − 0.14; P = 0.03) compared with the placebo. Additionally, Se supplementation significantly decreased PI of the uterine artery in Doppler ultrasound (β − 0.09; 95% CI, − 0.14, − 0.04; P = 0.04), and a significant improvement in depression (β − 5.63; 95% CI, − 6.97, − 4.28; P < 0.001), anxiety (β − 1.99; 95% CI, − 2.56, − 1.42; P < 0.001), and sleep quality (β − 1.97; 95% CI, − 2.47, − 1.46; P < 0.001). Se supplementation for 12 weeks in high-risk pregnant women in terms of PE screening with quad marker had beneficial effects on serum Se level, some metabolic profiles, uterine artery PI, and mental health. IRCT Registration: htpp:// www.irct.ir ; identifier IRCT20200608047701N1.

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Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: a population-based study

Cited by 15 publications

References 23 publications

Mitochondrial dysfunction-induced high hCG associated with development of fetal growth restriction and pre-eclampsia with fetal growth restriction

Mitochondrial dysfunction-induced high hCG associated with development of fetal growth restriction and pre-eclampsia with fetal growth restriction

Prediction of Pregnancy Complications With Maternal Biochemical Markers Used in Down Syndrome Screening

The Effect of Selenium Supplementation on Clinical Outcomes, Metabolic Profiles, and Pulsatility Index of the Uterine Artery in High-Risk Mothers in Terms of Preeclampsia Screening with Quadruple Test: a Randomized, Double-Blind, Placebo-Controlled Clinical Trial

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