Elevated second-trimester maternal serum hCG alone or in combination with elevated alpha-fetoprotein

被引:87
作者
Benn, PA
Horne, D
Briganti, S
Rodis, JF
Clive, JM
机构
[1] UNIV CONNECTICUT,CTR HLTH,DEPT PEDIAT,DIV HUMAN GENET,FARMINGTON,CT
[2] UNIV CONNECTICUT,CTR HLTH,DEPT OBSTET & GYNECOL,DIV MATERNAL FETAL MED,FARMINGTON,CT
[3] UNIV CONNECTICUT,CTR HLTH,LOWELL P WEICKER CLIN RES CTR,FARMINGTON,CT
关键词
D O I
10.1016/0029-7844(95)00390-8
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To evaluate the clinical significance of a second-trimester elevated maternal serum hCG in women carrying singleton, chromosomally normal fetuses. Methods: The results of second-trimester maternal serum screening (alpha-fetoprotein [MSAFP], hCG, and unconjugated estriol) for 25,438 women were reviewed, and those with hCG values exceeding 3.0 multiples of the median (MoM) were identified. A control population was selected only on the basis of samples accessioned by the laboratory at the same time as the study group. Follow-up information was collected from physicians' offices for both groups. Incidence of fetal or neonatal loss (spontaneous abortion, fetal death, and neonatal death combined), preterm birth (before 37 weeks' gestation), small for gestational age, and preeclampsia were compared. Results: Three hundred twenty-two women (1.3%) had hCG levels exceeding 3.0 MoM. In addition to chromosomal abnormalities and fetal death at the time of testing, this group showed a significantly higher incidence of fetal or neonatal death, preterm birth, low birth weight, and preeclampsia than did controls. For patients with elevated second-trimester hCG, many of the preterm deliveries occurred before 34 weeks' gestation. Logistic regression analysis indicated that hCG, MSAFP, and race were significant independent factors in predicting risk for adverse outcomes. Conclusions: Similar to elevated AFP, elevated hCG is associated with poor pregnancy outcome. By combining the results of the two tests, it may be possible to improve substantially the identification of patients at very high risk for adverse outcomes.
引用
收藏
页码:217 / 222
页数:6
相关论文
共 26 条
[11]  
CUCKLE HS, 1984, LANCET, V1, P926
[12]  
GONEN R, 1992, OBSTET GYNECOL, V80, P83
[13]   ELEVATED 2ND TRIMESTER MATERNAL SERUM BETA-HCG CONCENTRATIONS AND SUBSEQUENT ADVERSE PREGNANCY OUTCOME [J].
GRAVETT, CP ;
BUCKMASTER, JG ;
WATSON, PT ;
GRAVETT, MG .
AMERICAN JOURNAL OF MEDICAL GENETICS, 1992, 44 (04) :485-486
[14]  
Hosmer DW., 2000, APPL LOGISTIC REGRES, V2a
[15]   MATERNAL AGE AND INCIDENCE OF LOW BIRTH-WEIGHT AT TERM - A POPULATION STUDY [J].
LEE, KS ;
FERGUSON, RM ;
CORPUZ, M ;
GARTNER, LM .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1988, 158 (01) :84-89
[16]   AN ASSOCIATION BETWEEN ELEVATED LEVELS OF HUMAN CHORIONIC-GONADOTROPIN IN THE MIDTRIMESTER AND ADVERSE PREGNANCY OUTCOME [J].
LIEPPMAN, RE ;
WILLIAMS, MA ;
CHENG, EY ;
RESTA, R ;
ZINGHEIM, R ;
HICKOK, DE ;
LUTHY, DA .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1993, 168 (06) :1852-1857
[17]   THE CONTRIBUTION OF LOW BIRTH-WEIGHT TO INFANT-MORTALITY AND CHILDHOOD MORBIDITY [J].
MCCORMICK, MC .
NEW ENGLAND JOURNAL OF MEDICINE, 1985, 312 (02) :82-90
[18]   PREDICTIVE VALUES, RELATIVE RISKS, AND OVERALL BENEFITS OF HIGH AND LOW MATERNAL SERUM ALPHA-FETOPROTEIN SCREENING IN SINGLETON PREGNANCIES - NEW EPIDEMIOLOGIC DATA [J].
MILUNSKY, A ;
JICK, SS ;
BRUELL, CL ;
MACLAUGHLIN, DS ;
TSUNG, YK ;
JICK, H ;
ROTHMAN, KJ ;
WILLETT, W .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1989, 161 (02) :291-297
[19]   PROSPECTIVE MATERNAL SERUM HUMAN CHORIONIC-GONADOTROPIN SCREENING FOR THE RISK OF FETAL CHROMOSOME-ANOMALIES AND OF SUBSEQUENT FETAL AND NEONATAL DEATHS [J].
MULLER, F ;
AEGERTER, P ;
BOUE, A .
PRENATAL DIAGNOSIS, 1993, 13 (01) :29-43
[20]   MATERNAL SERUM HUMAN CHORIONIC-GONADOTROPIN LEVELS IN TWIN PREGNANCIES [J].
NEBIOLO, LM ;
ADAMS, WB ;
MILLER, SL ;
MILUNSKY, A .
PRENATAL DIAGNOSIS, 1991, 11 (07) :463-466