Ankara Üniversitesi Tıp Fakültesi Mecmuası

0365-8104 1307-5608

Ankara University

10.4274/atfm.galenos.2022.28199

Obstetrics and Gynocology Nursing

Doğum ve Kadın Hastalıkları Hemşireliği

Birinci ve İkinci Trimester Tarama Testlerinde Kullanılan Biyokimyasal Belirteçlerin Kötü Obstetrik Sonuçlarla İlişkisi

https://orcid.org/0000-0002-6956-5363

Cellek

Merve

Kırıkkale Yüksek İhtisas Hastanesi Çağlar

Ali Turhan

UNIVERSITY OF HEALTH SCIENCES, ANKARA ETLİK ZÜBEYDE HANIM HEALTH RESEARCH CENTER FOR GYNECOLOGICAL DISEASES

06 30 2022

75 2 286 294 06 15 2021 06 02 2022

1947

Ankara Üniversitesi Tıp Fakültesi Mecmuası

Objectives: This study aims to determine the relationship between poor obstetric and perinatal outcomes and maternal serum aneuploidy markersof first and second trimesters.Materials and Methods: Five hundred three singleton pregnancies who underwent prenatal screening for aneuploidy were examined. Theassociation between serum aneuploidy markers and poor obstetric and perinatal outcomes was investigated. In the regression analysis, adjustedodds ratio, 95% confidence interval and p-values were found for each marker.Results: The median Multiple of the Median (MoM) of pregnancy-associated plasma protein A was significantly lower in pregnancies with pregnancyinduced hypertension (0.63 vs 0.89, p=0.014). Women with elevated free β human chorionic gonadotropin (hCG) MoM levels were more likely toexperience intrauterine growth retardation (p=0.029). By examining low (≤10th percentile) alpha fetoprotein (AFP) MoM levels, we found a 9 foldincrease in risk of fetal death at or after 24 weeks of gestation (p=0.036). In case of high AFP levels, 5 fold increase in risk of IUGR was observed(p=0.023). While decreased levels of second-trimester hCG were associated with IUGR (p=0.011), increased risk of pregnancy induced hypertensionwas significantly associated with elevated hCG levels (p=0.001). Increased risk of abruptio placentae was associated with elevated hCG levels(p=0.023). Low levels of unconjugated estriol (uE3) appeared to be associated with pregnancy induced hypertension and low birth weight, the risksof which increased as depressed levels of uE3 became more extreme. Elevated hCG (31% vs 6%, p<0.001) and low uE3 (16.3% vs 6.2%, p=0.025)levels were associated with more need for neonatal intensive care in newborns. Reduced uE3 levels (at or below 10th percentile) were correlatedwith lower gestational age at birth (38.4 vs 39, p=0.038).Conclusion: A relationship was found between abnormal values of markers used in first and second trimester screening tests and poor obstetricresults. Triple screening hCG has been determined to be the best marker for predicting pregnancy induced hypertensive diseases.

Prenatal Screening Test Aneuploidy Markers Adverse Pregnancy Outcomes Perinatal Outcomes

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