Abstract
Purpose
The aim of this study was to evaluate the relationship between serum beta-human chorionic gonadotropin (β-hCG) and preeclampsia (PE) and the effects of βhCG on maternal and perinatal outcomes.
Methods
This case–control study included 125 pregnant women who were admitted to the labor ward of the Maternity Teaching Hospital, Erbil City, Kurdistan, Iraq between January and December 2016. Participants included 50 women with severe PE, 25 with mild PE, and 50 who were normotensive. Serum β-hCG concentrations during labor were compared between groups and maternal and perinatal outcomes were recorded.
Results
There were no significant differences in maternal age or parity distribution between the three groups. Gestational age was less than 37 weeks in 34% of the women with severe PE and in 12% of women in the mild PE and normotensive groups (p = 0.012). Mean β-hCG concentration was 37,520.56 mIU/mL in women with severe PE, 16,487 mIU/mL in those with mild PE, and 11,699.82 mIU/mL in those who were normotensive (p < 0.001). There were no significant differences in perinatal outcomes between groups; however, those with β-hCG concentrations ≥ 40,000 mIU/mL had worse neonatal outcomes (lower Apgar scores, higher rate of NICU admission, and lower survival rate) and unfavorable maternal outcomes (seizures, abruption, post-partum hemorrhage, and deep vein thrombosis).
Conclusions
There was a significant difference in β-hCG concentrations between women with PE and normotensive women. There were no significant differences in perinatal or maternal outcomes between groups, except in patients with β-hCG ≥ 40,000 mIU/mL.
Similar content being viewed by others
References
Redman CWG (1991) Current topic: pre-eclampsia and the placenta. Placenta 12:301–308
Hsu CD, Chan DW, Iriye B, Johnson TRB, Hong SF, Repke JT (1994) Elevated serum human chorionic gonadotropin as evidence of secretory response in severe preeclampsia. Am J Obstet Gynecol 170:1135–1138
Salas SP, Marshall G, Gutierrez BL, Rosso P (2005) Time course of maternal plasma volume and hormonal changes in women with preeclampsia or fetal growth restriction. Hypertension 47:203–208
Soundararajan P, Muthuramu P, Veerapandi M, Mariyappan R (2016) Serum beta chorionic gonadotropin and lipid profile in early second trimester (14–20 weeks) is a predictor of pregnancy-induced hypertension. Int J Reprod Contracept Obstet Gynecol 5:3011–3016
Norris W, Nevers T, Sharma S, Kalkunte S (2011) Review: hCG, preeclampsia and regulatory T cells. Placenta 32(Suppl 2):S182–S185. https://doi.org/10.1016/j.placenta.2011.01.009
Begum Z, Ara I, Tanira S, Keya KA (2014) The association between serum beta-human chorionic gonadotropin and preeclampsia. J Dhaka Med Coll 23:89–93
Hsu CD, Chan DW, Iriye B, Johnson TRB (1994) Elevated serum human chorionic gonadotropin as evidence of secretory response in severe preeclampsia. Am J Obstet Gynecol 170(4):1135–1138
Önderoğlu LS, Kabukçu A (1997) Elevated second trimester human gonadotropin level associated with adverse pregnancy outcome. Int J Gynaecol Obstet 6(3):245–249
Choudhury K, Das M, Ghosh S, Bhattacharya D, Ghosh TK (2012) Value of serum β-HCG in pathogenesis of pre-eclampsia. J Clin Gynecol Obstet 1(4–5):71–75
Gökdeniz R, Ariguloğlu E, Bazoğlu N, Balat Ö (2000) Elevated serum β-hCG levels in severe preeclampsia. Turk J Med Sci 30:43–45
National Institute for Health and Care Excellence (2010) Hypertension in pregnancy: diagnosis and management. NICE clinical guideline CG107. https://www.nice.org.uk/guidance/CG107. Accessed 11 Oct 2018
Committee on Obstetric practice American Academy of Pediatrics -Committee on Fetus and Newborn (2015) No. 644: The Apgar score. Obstet Gynecol 126(4):252–255. https://doi.org/10.1097/AOG0000000000001108
Royal College of Obstetricians and Gynecologists (2016) Postpartum hemorrhage, prevention and management (Green-top Guideline No. 52). https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.14178. Accessed 11 Oct 2018
Gubuz A, Karateke A, Mengulluoglu M, Gedikbasi A, Ozturkmen M, Kabaca C et al (2004) Can serum hCG values be used in the differential diagnosis of pregnancy complicated by hypertension? Hypertens Pregnancy 23:1–12
Yadav V, Verma AK, Soni N, Kaushik GG (2016) Broca JS (2016) Serum level of beta human chorionic gonadotropin in pathogenesis of pre-eclampsia. IJBHS 6(2):219–256
Kaur G, Jain V, Mehta S, Himani S (2012) Prediction of PIH by maternal serum beta HCG levels in the second trimester (13–20 weeks) of pregnancy. J Obstet Gynaecol India 62:32–34
Acknowledgements
The research team would like to thank all the women who generously shared their time and agreed to participate in this study. Special thanks to Professor Namir G. Al.Hawler Medical University, College of Medicine, Department of Community Erbil, Kurdistan Region, Iraq for helping with data analysis. We also thank Rebecca Tollefson, DVM, and Trish Reynolds, MBBS, FRACP, from Edanz Group (www.edanzediting.com/ac) for editing drafts of this manuscript.
Funding
This work was supported by the Kurdistan Board for Medical Specialties. Financial support was for academic purposes only.
Author information
Authors and Affiliations
Contributions
SIT data collection, manuscript writing, and data analysis. SKA project development, manuscript revision, and data management.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical standards
This study was conducted in accordance with the ethical standards of the Ethics and Scientific Committee of Kurdistan Board of Medical Specialties Nb. 30/0217 and with the Helsinki Declaration of 1975, as revised in 2000. Written informed consent to participate in the study was obtained from each woman. Participants were assured that confidentiality would be maintained and that their information would be used for research purposes only.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Taher, S.I., Alalaf, S.K. Association between serum beta-human chorionic gonadotropin and preeclampsia and its effects on perinatal and maternal outcomes: a case control study. Arch Gynecol Obstet 299, 713–718 (2019). https://doi.org/10.1007/s00404-019-05041-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-019-05041-y