Prediction of pre-eclampsia with maternal mid-trimester total renin, inhibin A, AFP and free beta-hCG levels

We wanted to study if maternal serum mid-trimester total renin, inhibin A, AFP or free beta-HCG levels predict the development of pre-eclampsia. Mater nal serum alpha-fetoprotein (AFP) and human chorion gonado-trophin (beta-hC G)were evaluated in the screening programme for Down syndrome in 4356 patie nts prospectively. Data on pregnancy outcome were available in 1242 women. Pregnancy-induced hypertension (PIH) developed in 69 women, 282 women with uneventful pregnancy outcome were selected for controls. Serum total renin and inhibin A levels were measured retrospectively in the trisomy screening samples of 69 and 30 patients who later developed PIH, and in 282 and 7 pa tients, respectively, who had an uneventful pregnancy outcome. No significa nt differences were found in the levels of maternal mid-trimester serum tot al renin, inhibin A or free beta-hCG levels between PIH and healthy women. The multiples of the median (MoM) of AFP values were significantly higher i n the subgroup of patients who later developed severe pre-eclampsia than in patients with mild pre-eclampsia or gestationaI hypertension and healthy p regnant women. Maternal mid-trimester serum levels of total renin, inhibin A and free beta-hCG are not predictive fur development of PIH. High mid-tri mester serum AFP values may help in the prediction of severe pre-eclampsia. Copyright (C) 1999 John Wiley & Sons, Ltd.