The association of triple-marker test results with adverse pregnancy outcomes in low-risk pregnancies with healthy newborns
- 264 Downloads
This study was designed to investigate the relationship between the second trimester maternal serum markers and adverse pregnancy outcomes in healthy newborns.
Materials and methods
A total of 749 women who delivered in our institution with complete follow up and second-trimester triple marker test data available were included in the study. Women with multiple pregnancies, chronic diseases, diabetes mellitus, obesity, smokers and infants with chromosomal and congenital abnormalities were excluded. Maternal serum alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and unconjugated estriol (uE3) values were investigated in our cohort who developed preeclampsia (n = 28), gestational diabetes (GM) (n = 69), preterm labor-birth (n = 100), oligohydramnios (n = 37) and macrosomia (n = 59) by using receiver operating characteristic (ROC) curve analysis, with chi-square and Pearson’s correlation tests.
Women with uE3 ≤ 1.26 MoM (P = 0.001, AUC = 0.666), HCG > 1.04 MoM (P = 0.032, AUC = 0.599) or AFP ≤ 0.69 MoM (P = 0.049, AUC = 0.600) values significantly developed oligohydramnios. Also, macrosomic infants were observed in women who had HCG values > 0.86 MoM (P = 0.047, AUC = 0.578). Patients with HCG > 1.04 MoM (P = 0.04, AUC = 0.565) and uE3 ≤0.88 MoM (P = 0.049, AUC = 0.571) developed GDM. HCG levels ≥2.5 or ≥3 MoM were significantly associated with the development of oligohydramnios [P = 0.005; OR = 4 (95% CI: 1.7–9.7)], [P = 0.008; OR = 4.9 (95% CI: 1.7–13.7)], respectively. When women with adverse (n = 237) and normal (n = 512) outcomes were compared there were significant differences in maternal serum AFP (1.40 ± 0.84 vs. 1.23 ± 0.75 MoM, P = 0.006) and uE3 values (1.38 ± 1.42 vs. 1.45 ± 0.98 MoM, P = 0.001).
Serum estriol, AFP or HCG values in triple test results may be associated with development of oligohydramnios, gestational diabetes and macrosomia in women with healthy and normal appearing fetuses.
KeywordsTurkish population Triple test Perinatal outcome
Conflict of interest: The authors have no connection to any of the companies or products mentioned in this article. We (the authors) state that we had full control of all primary data and we agree to allow the Journal to review our data if requested.
- 1.Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III LC, Wenstrom KD (2005) Williams obstetrics. 22nd edn. McGraw-Hill, New York pp 313–340Google Scholar
- 2.Yaron Y, Cherry M, Kramer RL, O’Brien JE, Hallak M, Johnson MP et al (1999) Second-trimester maternal serum marker screening: maternal serum α-fetoprotein, β-human chorionic gonadotropin, estriol, and their various combinations as predictors of pregnancy outcome. Am J Obstet Gynecol 181:968–974PubMedCrossRefGoogle Scholar
- 8.American Diabetes Association (2003) Position statement: gestational diabetes mellitus. Diabetes Care 26(Suppl. 1):S103–S105Google Scholar
- 13.Duric K, Skrablin S, Lesin J, Kalafatic D, Kuvacic I, Suchanek E (2003) Second trimester total human chorionic gonadotropin, alpha-fetoprotein and unconjugated estriol in predicting pregnancy complications other than fetal aneuploidy. Eur J Obstet Gynecol Reprod Biol 110:12–15PubMedCrossRefGoogle Scholar
- 25.Sayin NC, Varol FG, Duran R, Acunas B, Kurt I (2007) Perinatal outcome in women screened for gestational diabetes mellitus with normal or with one elevated glucose tolerance test value. J Turkish German Gynecol Assoc 8:38–43Google Scholar