Relationship between extreme values of first trimester maternal pregnancy associated plasma Protein-A, free-β-human chorionic gonadotropin, nuchal translucency and adverse pregnancy outcomes

GENÇ, Simten; Ozer, Hale; EMEKLİOGLU>, Cagdas Nurettin; Cıngıllıoğlu, Başak; Şahin, Orhan; Aktürk, Erhan; Şirinoğlu, Hicran Acar; Basaran, Nilgün; Mihmanlı, Veli

doi:10.1016/j.tjog.2022.02.043

Cited by 5 publications

(5 citation statements)

References 36 publications

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“…1. high PPV and NPV with high sensitivity and specificity at 5% false positivity 2. a screening test to predict IUGR in an unselected pregnant population. Since the studies in the literature were generally conducted between 1-15 centers over 2-7 years and generally investigated all poor pregnancy outcomes such as preeclampsia, IUGR, preterm labor, preterm rupture of membranes, etc., this study seems to be outnumbered 14 . This study seems to be outnumbered because it included all births at all weeks in the study.…”

Section: Discussionmentioning

confidence: 67%

First-Trimester Screening Tests and Perinatal Outcomes

Suman,

Gök,

Büyük

et al. 2024

İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi

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Aim: Early diagnosis of trisomies occupies an important place in the working life of perinatologists and obstetricians. Early diagnosis of this condition is very important in raising a healthy generation. Early diagnosis informs decisions such as mental and physical preparation after birth or termination of pregnancy. Early detection of this risk is ensured by testing fetal nuchal translucency (NT), free human chorionic gonadotropin-β (free-βhCG) and pregnancy-related plasma protein-A (PAPP-A) levels at appropriate intervals. Also, with the help of these tests, perinatal risks such as chromosomal abnormalities, intrauterine growth retardation (IUGR) and preterm birth can be detected, and precautionary measures can be taken. In this study, we are trying to find out if it is possible to predict IUGR using these tests in the first trimester and evaluating the infants born here. Perhaps retrospective evaluation of these tests can be used to prevent poor pregnancy outcomes or, if necessary, to reduce the incidence of complications by delivering babies in more appropriate centers. Method: One of the hospitals included in this study is a training and research hospital and the other is a state hospital with active birth management, where the number of births is higher than the regional average. This study was conducted using data obtained by pediatrics and obstetrics by scanning the records of patients who had gone to their centers for postnatal care and the babies who were born. The population that served as the control group was reached in the same way. The period for the study was limited to two years. Results: 257 patients who had enrolled in centers for prenatal care over two years were included in the study. While 132 healthy pregnant women participated in the study as a control group, 125 pregnant women diagnosed with IUGR were included in the study. When the screening tests were compared in the first trimester, the mean PAPP-A level was higher in the control group than in the patient group (p=0.006). Free β-hCG was also higher in the control group (p=0.024). The result after performing the necessary statistical adjustments PAPP-A showed the statistical significance of its value in the analysis. However, the same tests did not show the same success in the IUGR group and were not statistically successful in predicting poor neonatal outcomes. Conclusion: In this study, the use of PAPP-A level in the first trimester has been shown to provide successful results in estimating IUGR that may occur later in pregnancy. However, no parameter has shown the same predictive success in predicting poor neonatal outcomes.

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Section: Discussionmentioning

confidence: 67%

First-Trimester Screening Tests and Perinatal Outcomes

Suman,

Gök,

Büyük

et al. 2024

İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi

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“…Low serum β-hCG was also found to increase the risks of adverse obstetric outcomes. Thus, the two biomarkers were identified as useful biomarkers for predicting the risks of fetal growth restrictions [44]. Wang et al examined the association between oxidative stress, serum β-hGC, and pregnancy-induced hypertension [45].…”

Section: Resultsmentioning

confidence: 99%

Role of First Trimester Screening Biochemical Markers to Predict Hypertensive Pregnancy Disorders and SGA Neonates—A Narrative Review

Górczewski,

Górecka,

Massalska-Wolska

et al. 2023

Healthcare

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Early recognition of high-risk pregnancies through biochemical markers may promote antenatal surveillance, resulting in improved pregnancy outcomes. The goal of this study is to evaluate the possibilities of using biochemical markers during the first trimester of pregnancy in the prediction of hypertensive pregnancy disorders (HPD) and the delivery of small-for-gestational-age (SGA) neonates. A comprehensive search was conducted on key databases, including PubMed, Scopus, and Web of Science, for articles relating to the use of biochemical markers in the prediction of HPD and SGA. The findings show that changes in the levels of biomarkers in the early pregnancy phases could be an important indicator of adverse pregnancy outcomes. The literature shows that low PAPP-A (pregnancy-associated plasma protein A) and PlGF (placental growth factor) levels, low alkaline phosphatase (AP), higher sFlt-1 (soluble fms-like Tyrosine Kinase-1) levels, higher AFP (alfa fetoprotein) levels, and elevated levels of inflammatory markers such as β-HGC (free beta human chorionic gonadotropin), interferon-gamma (INF-γ), and tumor necrosis factor-α (TNF-α) may be associated with risks including the onset of HPD, fetal growth restriction (FGR), and delivery of SGA neonates. Comparatively, PAPP-A and PlGF appear to be the most important biochemical markers for the prediction of SGA and HPD.

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“…Recently, a large-scale study in Turkish population has reported association between serum levels of PAPP-A and SGA, while GDM, PROM and preterm PPROM have been more common in pregnant women with low serum free β-hCG 23 . The latter finding is in accordance with our finding regarding the higher frequencies of PROM among pregnant women having levels of free βHCG MoM < 0.2.…”

Section: Discussionmentioning

confidence: 99%

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

Younesi¹,

Eslamian

Khalafi³

et al. 2023

Sci Rep

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Multiples of the normal median (MoM) of free βHCG is a valuable parameter in evaluation of risk of adverse pregnancy outcomes. In the current retrospective study, we assessed the maternal and fetal outcomes in pregnant women having free βHCG MoM levels < 0.2 or > 5 in their first trimester screening (FTS). Relative risk of trisomy 21 was significantly higher in patients having free βHCG MoM > 5. On the other hand, relative risk of trisomies 13 and 18 and Turner syndrome were higher in those having free βHCG MoM < 0.2. Other chromosomal abnormalities were nearly equally detected between those having free βHCG MoM < 0.2 or > 5. Relative risk of hydrocephaly and hydrops fetalis was higher when free βHCG MoM was below 0.2. On the other hand, relative risk of low birth weight was higher when free βHCG MoM was above 5. Moreover, frequency of gestational diabetes mellitus, preeclampsia, preterm delivery and vaginal bleeding increased with levels of free βHCG MoM. However, polyhydramnios had the opposite trend. Frequencies of premature rupture of membranes and pregnancy induced hypertension were highest among pregnant women having levels of free βHCG MoM < 0.2. The current study indicates importance of free βHCG MoM in identification of at-risk pregnancies in terms of both fetal and maternal outcomes. In fact, βHCG MoM < 0.2 or > 5 can be regarded as risk factors for adverse maternal or fetal outcomes irrespective of the presence of other abnormalities in the FTS results.

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Relationship between extreme values of first trimester maternal pregnancy associated plasma Protein-A, free-β-human chorionic gonadotropin, nuchal translucency and adverse pregnancy outcomes

Cited by 5 publications

References 36 publications

First-Trimester Screening Tests and Perinatal Outcomes

First-Trimester Screening Tests and Perinatal Outcomes

Role of First Trimester Screening Biochemical Markers to Predict Hypertensive Pregnancy Disorders and SGA Neonates—A Narrative Review

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

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