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Effect of smoking on pregnancy-associated plasma protein A, free β-human chorionic gonadotropin, and nuchal translucency in the first trimester of pregnancy

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Abstract

Data were collected from 1275 pregnant Turkish women screened prospectively for chromosomal anomalies to determine whether first-trimester levels of maternal serum pregnancy-associated plasma protein A (PAPP-A) and free β-human chorionic gonadotropin (β-hCG) and the thickness of nuchal translucency are affected by smoking and other covariables. Only normal singleton pregnancies were included. After weight correction, comparisons were made between smokers and nonsmokers. Mean values of PAPP-A and β-hCG were reduced in women who smoked 5 or more cigarettes a day compared with nonsmokers. The median β-hCG level decreased significantly as gravidity and parity increased; no effect was noted on PAPP-A. Median PAPP-A and β-hCG levels tended to increase, but not significantly in women who had had 2 or more miscarriages. Smoking alters maternal levels of serum analytes, with the magnitude of the impact related to the number of cigarettes smoked per day. This effect can be detected in the first trimester of pregnancy.

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References

  1. Spencer K, Spencer CE, Power M, Dawson C, Nicolaides KH. Screening for chromosomal abnormalities in the first trimester using ultrasound and maternal serum biochemistry in a one stop clinic: a review of three years’ prospective experience.Br J Obstet Gynaecol. 2003; 110: 281–286.

    CAS  Google Scholar 

  2. Spencer K, Souter V, Tul N, Snijders R, Nicolaides KH. A screening program for trisomy 21 at 10–14 weeks using fetal nuchal translucency, maternal serum free beta-human chorionic gonadotropin and pregnancy associated plasma protein-A.Ultrasound Obstet Gynecol. 1999; 13: 231–237.

    Article  PubMed  CAS  Google Scholar 

  3. Bindra R, Heath V, Liao A, Spencer K, Nicolaides KH. One stop clinic for assessment of risk for trisomy 21 at 11–14 weeks: a prospective study of 15,030 pregnancies.Ultrasound Obstet Gynecol. 2002; 20: 219–225.

    Article  PubMed  CAS  Google Scholar 

  4. Haddow JE, Palomaki GE, Knight GK. Effect of parity on human chorionic gonadotrophin levels and Down’s syndrome screening.J Med Screen. 1995; 2: 28–30.

    PubMed  CAS  Google Scholar 

  5. Wald NJ, Cuckle HS, Densem JW, et al. Maternal serum screening for Down’s syndrome in early pregnancy.BMJ. 1988; 297: 883–888.

    Article  PubMed  CAS  Google Scholar 

  6. Spencer K. The influence of smoking on maternal serum AFP and free beta hCG levels and the impact on screening for Down syndrome.Prenat Diagn. 1998; 18: 225–234.

    Article  PubMed  CAS  Google Scholar 

  7. Haddow JE, Palomaki G, Kloza EM, Knight GJ, Wylie P. Does smoking influence serum AFP levels in mid-trimester pregnancies?Br J Obstet Gynaecol. 1984; 91: 1189–1191.

    Google Scholar 

  8. Bartels I, Hoppe-Sievert B, Bockel B, Herold S, Caesar J. Adjustment formulae for maternal serum alpha-fetoprotein, human chorionic gonadotropin, and unconjugated oestriol to maternal weight and smoking.Prenat Diagn. 1993; 13: 123–130.

    Article  PubMed  CAS  Google Scholar 

  9. Crossley JA, Aitken DA, Waugh SML, Kelly T, Connor JM. Maternal smoking, age distribution, levels of alpha-fetoprotein and human chorionic gonadotrophin, and effect on detection of Down syndrome pregnancies in second trimester screening.Prenat Diagn. 2002; 22: 247–255.

    Article  PubMed  CAS  Google Scholar 

  10. Cuckle HS, Wald NJ, Densem JW, et al. The effect of smoking in pregnancy on maternal serum alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin, progesterone and dehydro-epiandrosterone sulphate levels.Br J Obstet Gynaecol. 1990; 97: 272–274.

    PubMed  CAS  Google Scholar 

  11. Spencer K, Bindra R, Cacho AM, Nicolaides KH. The impact of correcting for smoking status when screening for chromosomal anomalies using maternal serum biochemistry and fetal nuchal translucency thickness in the first trimester of pregnancy.Prenat Diagn. 2004; 24: 169–173.

    Article  PubMed  Google Scholar 

  12. Niemimaa M, Heinonen S, Seppala M, Ryynanen M. The influence of smoking on the pregnancyassociated plasma protein A, free beta human chorionic gonadotrophin and nuchal translucency.Br J Obstet Gynecol. 2003; 110: 664–667.

    CAS  Google Scholar 

  13. Spencer K, Ong CY, Liao AW, Papademetriou D, Nicolaides KH. First trimester markers of trisomy 21 and the influence of maternal cigarette smoking status.Prenat Diagn. 2000; 20: 852–853.

    Article  PubMed  CAS  Google Scholar 

  14. De Graaf IM, Cuckle HS, Pajkrt E, Leschot NJ, Bleker OP, van Lith JM. Co-variables in first trimester maternal serum screening.Prenat Diagn. 2000; 20: 186–189.

    Article  PubMed  Google Scholar 

  15. Spencer K. The influence of smoking on maternal serum PAPP-A and free beta hCG levels in the first trimester of pregnancy.Prenat Diagn. 1999; 9: 1065–1066.

    Article  Google Scholar 

  16. Spencer K, Bindra R, Nicolaides KH. Maternal weight correction of maternal serum PAPP-A and free β-hCG when screening for trisomy 21 in the first trimester of pregnancy.Prenat Diagn. 2003; 23: 851–855.

    Article  PubMed  Google Scholar 

  17. Chen CL, Gilbert TJ, Darling JR. Maternal smoking and Down’s syndrome: the confounding effect of maternal age.Am J Epidemiol. 1999; 149: 442–446.

    PubMed  CAS  Google Scholar 

  18. Kozan O, Oguz A, Erol C. Türkiye Metabolik Sendrom Sıklıgı Arastirmasi (METSAR): amac ve protokol.Kardiyoloji Dergisi. 2003; 10: 4.

    Google Scholar 

  19. Souka AP, Krampl E, Bakalis S, Heath V, Nicolaides KH. Outcome of pregnancy in chromosomally normal fetuses with increased nuchal translucency in the first trimester.Ultrasound Obstet Gynecol. 2001; 18: 9–17.

    Article  PubMed  CAS  Google Scholar 

  20. Greco P, Loverro G, Vimercati A, Marzullo A, Caruso G, Selvaggi L. Pathological significance of first-trimester fetal nuchal oedema.Prenat Diagn. 1996; 16: 503–509.

    Article  PubMed  CAS  Google Scholar 

  21. Zimmermann R, Streicher A, Huch R, Huch A. Effect of gravidity and parity on the parameters used in serum screening for trisomy 21.Prenat Diagn. 1995; 15: 781–782.

    Article  PubMed  CAS  Google Scholar 

  22. Spencer K. The influence of gravidity on Down’s syndrome screening with free beta hCG.Prenat Diagn. 1995; 15: 87–89.

    Article  PubMed  CAS  Google Scholar 

  23. Ferriman EL, Sehmi IK, Jones R, Cuckle HS. The effect of smoking in pregnancy on maternal serum inhibin A.Prenat Diagn. 1999; 19: 179–182.

    Article  Google Scholar 

  24. Palomaki GE, Knight GJ, Haddow JE, Canick JA, Wald NJ, Kennard A. Cigarette smoking and levels of maternal serum alpha-fetoprotein, unconjugated estriol, and hCG: impact on Down syndrome screening.Obstet Gynecol. 1993; 81: 675–678.

    PubMed  CAS  Google Scholar 

  25. Rudnicka AJ, Wald NJ, Huttly W, Hackshaw AK. Influence of maternal smoking on the birth prevalence of Down syndrome and on second trimester screening performance.Prenat Diagn. 2002; 22: 893–897.

    Article  PubMed  Google Scholar 

  26. Demir R, Demir AY, Yinanc M. Structural changes in placental barrier of smoking mother: a quantitative and ultrastructural study.Pathol Res Pract. 1994; 190: 656–667.

    PubMed  CAS  Google Scholar 

  27. Marana HR, Andrade JM, Martins GA, Silva JS, Sala MA, Cunha SP. A morphometric study of maternal smoking on apoptosis in the syncytiotrophoblast.Int J Gynaecol Obstet. 1998; 61: 21–27.

    Article  PubMed  CAS  Google Scholar 

  28. Jauniaux E, Burton GJ. The effect of smoking in pregnancy on early placental morphology.Obstet Gynecol. 1992; 79: 645–648.

    PubMed  CAS  Google Scholar 

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Yigiter, A.B., Kavak, Z.N., Bakirci, N. et al. Effect of smoking on pregnancy-associated plasma protein A, free β-human chorionic gonadotropin, and nuchal translucency in the first trimester of pregnancy. Adv Therapy 23, 131–138 (2006). https://doi.org/10.1007/BF02850353

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