First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: A population-based screening study (The FASTER Trial) - 25/08/11

Doi : 10.1016/j.ajog.2004.06.052

Lorraine Dugoff, MD ^a, John C. Hobbins, MD ^a, Fergal D. Malone, MD ^b, T. Flint Porter, MD ^c, David Luthy, MD ^d, Christine H. Comstock, MD ^e, Gary Hankins, MD ^f, Richard L. Berkowitz, MD ^g, Irwin Merkatz, MD ^h, Sabrina D. Craigo, MD ⁱ, Ilan E. Timor-Tritsch, MD ^j, Steven R. Carr, MD ^k, Honor M. Wolfe, MD ^l, John Vidaver, MA ^m, Mary E. D'Alton, MD ^b
^a Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver, Colo
^b Department of Obstetrics and Gynecology, Columbia University, New York, NY
^c Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
^d Swedish Medical Center, Seattle, Wash
^e William Beaumont Hospital, Royal Oak, Mich
^f Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Tex
^g Mount Sinai School of Medicine, Obstetrics, Gynecology, and Reproductive Science, New York, NY
^h Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, NY
ⁱ Department of Obstetrics and Gynecology, Tufts University, Boston, Mass
^j New York University, New York, NY
^k Brown University, Providence, RI
^l UNC Medical Center, Chapel Hill, NC
^m DM-Stat, Inc, Boston, Mass

for the FASTER Trial Research Consortium

Abstract

Objective

The purpose of this study was to determine whether maternal serum levels of pregnancy-associated plasma protein A, free-beta subunit human chorionic gonadotropin, or nuchal translucency size are associated with obstetric complications.

Study design

Data were obtained from the First and Second Trimester Evaluation of Risk trial. Pregnancy-associated plasma protein A and free-beta subunit human chorionic gonadotropin levels were analyzed, and nuchal translucency was measured between 10 weeks 3 days and 13 weeks 6 days of gestation in 34,271 pregnancies.

Results

Women with pregnancy-associated plasma protein A of ≤5th percentile were significantly more likely to experience spontaneous fetal loss at ≤24 weeks of gestation, low birth weight, preeclampsia, gestational hypertension, preterm birth (P < .001) and stillbirth, preterm premature rupture of membranes, and placental abruption (P < .02). Nuchal translucency at ≥99th percentile and free-beta subunit human chorionic gonadotropin at ≤1st percentile were associated with an increased risk of spontaneous loss at ≤24 weeks of gestation (adjusted odds ratios, 3.90, 3.62, respectively; P < .001).

Conclusion

Low pregnancy-associated plasma protein A levels in the first trimester were associated strongly with a number of adverse pregnancy outcomes. Low free-beta subunit human chorionic gonadotropin levels and large nuchal translucency were both associated with early fetal loss.

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Key words : Pregnancy-associated plasma protein A, Free-beta human chorionic gonadotropin, Nuchal translucency

Plan

Supported by National Institute of Child Health and Human Development grant no. RO1-HD 38652.
Presented at the Twenty-Fourth Annual Meeting of the Society for Maternal-Fetal Medicine, February 2-7, 2004, New Orleans, La.
Reprints not available from the authors.

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Vol 191 - N° 4

P. 1446-1451 - octobre 2004 Retour au numéro

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Association of extreme first-trimester free human chorionic gonadotropin-β, pregnancy-associated plasma protein A, and nuchal translucency with intrauterine growth restriction and other adverse pregnancy outcomes
David Krantz, Laura Goetzl, Joe Leigh Simpson, Elizabeth Thom, Julia Zachary, Terrence W. Hallahan, Richard Silver, Eugene Pergament, Lawrence D. Platt, Karen Filkins, Anthony Johnson, Maurice Mahoney, W. Allen Hogge, R. Douglas Wilson, Patrick Mohide, Douglas Hershey, Ronald Wapner

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First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: A population-based screening study (The FASTER Trial) - 25/08/11

Abstract

Objective

Study design

Results

Conclusion

Plan

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