Elevated second trimester human chorionic gonadotropin level associated withadverse pregnancy outcome

Abstract

Objective: Our purpose was to determine whether unexplained elevations in maternal serum human chorionic gonadotropin in the second trimester may be associated with adverse pregnancy outcome. Method: Between April 1992 and April 1995, 610 pregnant women undergoing second trimester triple marker screening for Down syndrome who delivered at our institution were evaluated. Eighty-one women with a hCG level greater than 2.0 multiples of the median (MoM) were included in the study group while 481 women with hCG levels < 2.0 MoM served as controls. Pregnancies with fetal chromosomal and structural anomalies and maternal serum alpha-fetoprotein levels greater than 2.0 MoM were excluded from the study. Pregnancy outcomes were obtained from hospital delivery records. Statistical analysis were performed by Student's t-test; odds ratios and 95% confidence intervals were also calculated. Results: Women with elevated human chorionic gonadotropin levels showed an increased risk for preeclampsia (odds ratio (OR): 5.93, 95% confidence interval (CI): 1.97–15.88), intrauterine growth retardation (OR: 5.34, 95% CI: 2.14–13.34), preterm delivery (OR: 5.66, 95% CI: 3.22–9.98), and preterm premature rupture of membranes (OR: 3.15, 95% CI: 1.23–8.07). Conclusion: Unexplained elevation of human chorionic gonadotropin in the second trimester appears to be associated with adverse pregnancy outcome.