THE ASSOCIATION BETWEEN HYPERTENSIVE DISORDERS OF PREGNANCY AND ABNORMAL 2ND-TRIMESTER MATERNAL SERUM LEVELS OF HCG AND ALPHA-FETOPROTEIN

Objective: To examine the association between hypertensive disorders o f pregnancy and second-trimester maternal serum alpha-fetoprotein (MSA FP) and hCG levels. Methods: The proportions of abnormal second-trimes ter MSAFP and hCG levels in the serum samples from 65 women with true pregnancy-induced hypertension or preeclampsia (cases) were compared t o the proportions of abnormal levels in all 1943 women without this di sorder in the same cohort in a hospital setting. Maternal serum alphaf etoprotein and hCG levels of the 65 cases also were compared to those of 325 completely uncomplicated matched control pregnancies, selected from the same cohort. Fisher exact test and Student t test were used f or statistical analysis and P < .05 was considered statistically signi ficant. Results: An MSAFP level at least 2.5 multiples of the median ( MoM) was found in two of 65 cases (3.1%) and in 27 of 1943 women (1.4% ) in the rest of the cohort, a nonsignificant difference (relative ris k [RR] = 2.2; P = .24). The statistical power to identify a significan t difference for this RR was .27. An hCG level of at least 2.5 MoM was found in six cases (9.2%) and in 89 (4.6%) of women in the rest of th e cohort, also a nonsignificant difference (RR = 2.0; P = .12). The st atistical power to identify a significant difference for this RR was . 38. The mean (+/- standard deviation) logarithms of the MSAFP and hCG MoMs in the 65 cases (0.039 +/- 0.191 and 0.048 +/- 0.265, respectivel y) were not significantly different from those in the 325 matched cont rols (0.006 +/- 0.148 and -0.010 +/- 0.244, respectively; P = .12 and .08, respectively). Conclusion: Although a weak association cannot be excluded, this study found no clinically important increase in risk of developing subsequent hypertensive disorders of pregnancy among women with abnormal second-trimester levels of MSAFP or hCG. (C) 1997 by Th e American College of Obstetricians and Gynecologists.