Abnormal First And Second Trimester Matenal Seum Marker Levels For Aneuploidy Screening And Adverse Pregnancy Outcomes

INTRODUCTION: To investigate if there is an association between pregnancy complications and abnormal maternal serum analytes used for first and second trimester screening for aneuploidy.
METHODS: Between July 2009 and January 2010, 218 pregnant women who had first or second trimester screening for birth Down syndrome were entered. First trimester maternal serum levels of PAPP-A and free hCG or second trimester maternal serum levels of AFP, hCG and uE3 were compared between normal pregnancies and pregnancies complicated with preeclampsia, intrauterine growth retardation, intrauterine fetal death or oligohydramnios.
RESULTS: PAPP-A levels below 0.4 MoMs were associated with an increased risk of preeclampsia and fetal growth retardation. AFP levels over 2.5 MoMs were associated with all of the 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 associated with an increased incidence of preeclampsia, elevated second trimester hCG levels over 3.0 MoMs were associated with fetal growth retardation. No significant relationship could be established between low first trimester free hCG levels (less than 0.5 MoMs) and any of the adverse outcomes.
DISCUSSION AND CONCLUSION: There are significant associations between first and second trimester serum analytes for Down syndrome screening and adverse pregnancy outcomes. However, due to their low sensitivity and positive predictive values, these analytes are not proven to be effective in the