Predicting complications of pregnancy with first‐trimester maternal serum free‐βhCG, PAPP‐A and inhibin‐A

Abstract

Objective To find whether fβhCG, PAPP‐A and inhibin‐A levels in maternal serum or fetal nuchal translucency (NT) thickness at the first‐trimester screening for trisomy 21 (T21) might detect women at high risk for adverse pregnancy outcomes. Methods A retrospective analysis of 1136 women with singleton pregnancy between 10 and 14 weeks. Women with pregnancy complications were allotted to five subgroups: small for gestational age (SGA), large for gestational age (LGA), gestational diabetes (GDM), hypertensive disorders, preterm delivery; women with normal pregnancy represented the control group. NT, maternal serum fβhCG, PAPP‐A and inhibin‐A were measured. Mann–Whitney test was used for the comparison of fβhCG, PAPP‐A, inhibin‐A and NT between a subgroup of a certain pregnancy complication and the control group. Multivariate logistic regression models were built to explore the relationship among different variables and the occurrence of pregnancy complications. Results PAPP‐A values were significantly lower in women who delivered SGA babies (n = 51, 0.76 MoM; p = 0.002) and significantly higher in women who delivered LGA babies (n = 120, 1.12 MoM; p = 0.036). In women with GDM (n = 27), fβhCG, PAPP‐A and inhibin‐A were insignificantly lower than in controls, whereas in women with hypertensive disorders (n = 56) no significant differences between the groups were found. In women with a preterm delivery (n = 17), inhibin‐A levels were significantly higher (1.25 MoM; p = 0.015). Conclusion Low PAPP‐A level is associated with the delivery of an SGA baby and high PAPP‐A with the delivery of an LGA baby. High inhibin‐A is associated with preterm delivery before 34 weeks. Feto‐placental products in the first trimester do not prove to be useful as a screening tool for predicting pregnancy complications. Copyright © 2003 John Wiley & Sons, Ltd.