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)

• Published in: American journal of obstetrics and gynecology 2004-10, Vol.191 (4), p.1446-1451
• Main Authors: Dugoff, Lorraine, Hobbins, John C., Malone, Fergal D., Porter, T. Flint, Luthy, David, Comstock, Christine H., Hankins, Gary, Berkowitz, Richard L., Merkatz, Irwin, Craigo, Sabrina D., Timor-Tritsch, Ilan E., Carr, Steven R., Wolfe, Honor M., Vidaver, John, D'Alton, Mary E.
• Format: Article
• Language: English
• Subjects: Abortion, Spontaneous - blood; Abruptio Placentae - blood; Biological and medical sciences; Chorionic Gonadotropin, beta Subunit, Human - blood; Confounding Factors (Epidemiology); Delivery. Postpartum. Lactation; Female; Fetal Membranes, Premature Rupture - blood; Free-beta human chorionic gonadotropin; Gynecology. Andrology. Obstetrics; Humans; Maternal Age; Medical sciences; Multicenter Studies as Topic; Nuchal translucency; Nuchal Translucency Measurement; Predictive Value of Tests; Pregnancy; Pregnancy Complications - blood; Pregnancy Outcome; Pregnancy Trimester, First - physiology; Pregnancy-associated plasma protein A; Pregnancy-Associated Plasma Protein-A - analysis; Premature Birth - blood
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2004.06.052

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. 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. 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). 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.