Journal article
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
American journal of obstetrics and gynecology, v 191(4), pp 1452-1458
Oct 2004
PMID: 15507982
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The purpose of this study was to determine the association between first-trimester trisomy 21 screening markers (free human chorionic gonadotropin-β [hCG], pregnancy-associated plasma protein A [PAPP-A], and nuchal translucency) and adverse pregnancy outcome.
This was a cohort study of 8012 patients enrolled in a National Institute of Child Health and Human Development–sponsored study of first-trimester trisomy 21 and 18 screening. Trisomy 21 and 18 risk results and individual marker levels in unaffected pregnancies and pregnancies with adverse outcomes were evaluated.
PAPP-A <1st percentile (OR 5.4, 95% CI 2.8-10.3) and PAPP-A <5th percentile (OR 2.7, 95% CI 1.9-3.9) and free β-hCG <1st percentile (OR 2.7, 95% CI 1.3-5.9) were associated with increased risk of intrauterine growth restriction (IUGR) with positive predictive values of 24.1%, 14.1%, and 14.3%, respectively. PAPP-A <5th percentile (OR 2.3 95% CI 1.1-4.7) and nuchal translucency >99th percentile (OR 3.5, 95% CI 1.1-11.3) were associated with increased risk of preterm delivery before 34 weeks. Increased risk at screening for trisomy 21 and 18 identified 16 of the 29 other chromosomal abnormalities (55%). Low free β-hCG, low PAPP-A, and increased nuchal translucency were all associated with an increased rate of fetal abnormality.
Extreme values of first-trimester free β-hCG, PAPP-A, and nuchal translucency are all associated with adverse outcomes. The especially high predictive value for IUGR of PAPP-A levels below the 1st percentile suggests that patients within this group may benefit from increased surveillance for this condition.
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Details
- Title
- 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
- Creators
- David Krantz - NTD Laboratories, Huntington Station, NYLaura Goetzl - Baylor College of MedicineJoe Leigh Simpson - Baylor College of MedicineElizabeth Thom - George Washington UniversityJulia Zachary - George Washington UniversityTerrence W. Hallahan - NTD Laboratories, Huntington Station, NYRichard Silver - Evanston HospitalEugene Pergament - Northwestern Memorial HospitalLawrence D. Platt - Cedars-Sinai Medical CenterKaren Filkins - University of California, Los AngelesAnthony Johnson - Wayne State UniversityMaurice Mahoney - YALE UNIVERSITY, NEW HAVEN, CONN.W. Allen Hogge - Magee-Womens HospitalR. Douglas Wilson - British Columbia Centre of Excellence for Women's HealthPatrick Mohide - McMaster University Medical CentreDouglas Hershey - Northern California ResearchRonald Wapner - Drexel UniversityFirst Trimester Maternal Serum BioMichael J Mahoney - Creative Arts Therapies
- Publication Details
- American journal of obstetrics and gynecology, v 191(4), pp 1452-1458
- Publisher
- Mosby, Inc
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Creative Arts Therapies
- Web of Science ID
- WOS:000224812100064
- Scopus ID
- 2-s2.0-7044261025
- Other Identifier
- 991019169597004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Obstetrics & Gynecology