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The association of triple-marker test results with adverse pregnancy outcomes in low-risk pregnancies with healthy newborns

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Abstract

Objective

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.

Results

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).

Conclusions

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.

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Acknowledgment

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.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Trakya University, Edirne, Turkey

    N. Cenk Sayın, Nefize Ahmet, Sezer Arda & Füsun G. Varol

  2. Kent Hospital, Izmir, Turkey

    M. Tunç Canda

  3. Department of Biostatistics, Trakya University, Edirne, Turkey

    Necdet Süt

  4. Trakya Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum A.D, 22030, Edirne, Turkey

    N. Cenk Sayın

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  1. N. Cenk Sayın
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  2. M. Tunç Canda
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Correspondence to N. Cenk Sayın.

Additional information

Presented in part at the VI. Congress of the Turkish-German Gynecological Association, Antalya, May 18–22, 2005. Abstract, S12, Arch Gynecol Obstet 2005; 271 (Suppl 1-Abstract Book): Poster-MFM&P-32.

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Sayın, N.C., Canda, M.T., Ahmet, N. et al. The association of triple-marker test results with adverse pregnancy outcomes in low-risk pregnancies with healthy newborns. Arch Gynecol Obstet 277, 47–53 (2008). https://doi.org/10.1007/s00404-007-0421-6

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  • DOI: https://doi.org/10.1007/s00404-007-0421-6

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