Abnormal first and second trimester maternal serum marker levels for aneuploidy screening and adverse pregnancy outcomes

Abstract

To investigate if there is an association between pregnancy complications and abnormal maternal serum analytes used for first trimester screening (FTS) and second trimester screening (STS) for aneuploidy. More than two hundred three pregnant women who had FTS or STS for Down's syndrome who presented between July 2009 and January 2010 were included. First trimester maternal levels of PAPP-A and free hCG or 2nd trimester maternal levels of AFP, uE3 and hCG were compared between healthy pregnancies and those with preeclampsia, intrauterine growth retardation, intrauterine fetal death or oligohydramnios. PAPP-A levels less than 0.4 MoMs were related with elevated preeclampsia and fetal growth retardation risk. AFP levels over 2.5 MoMs were related with all adverse outcomes evaluated in the study including preeclampsia, fetal growth retardation, intrauterine fetal demise and oligohydramnios. While uE3 levels below 0.5 MoM were found to be related with higher preeclampsia incidence, elevated 2nd trimester hCG levels over 3.0 MoMs were associated with fetal growth retardation. No significant relationship could be established between low 1st trimester free hCG levels (less than 0.5 MoMs) and any of the adverse outcomes. First and 2nd trimester serum analytes for Down syndrome screening are significantly linked with pregnancy complications. However, because their sensitivity and positive predictive values are low, these analytes are not shown to be effective in the screening of pregnancy complications when used alone.