Second-trimester levels of maternal serum human chorionic gonadotropin andinhibin A as predictors of preeclampsia in the third trimester of pregnancy

OBJECTIVE: To determine whether second-trimester maternal scrum levels of i nhibin A, human chorionic gonadotropin (hCG), unconjugated estriol (uE3), a nd alpha-fetoprotein (AFP) are predictive of the later onset of preclampsia in pregnancy. METHODS: Retrospective evaluation of serum analyte levels in 60 women with preeclampsia compared with 300 controls. Levels of each analyte were compar ed in women with preeclampsia and controls using matched rank analysis. Ana lytes that were significantly different between groups were examined with u nivariate and bivariate Gaussian distribution analysis. RESULTS: Second-trimester inhibin A (1.36 multiples of the median [MoM]) an d hCG (1.40 Mom) levels were significantly but modestly elevated in women w ho later developed preeclampsia with 95% specificity. There was a statistic ally significant trend for inhibin A, but not hCG, levels to be higher when the onset of preeclampsia occurred within a shorter (< 17 weeks ) interval after collection of the second-trimester screening sample. CONCLUSIONS: Second-trimester serum levels of inhibin A and hCG are modest predictor of the later onset of preeclampsia. Inhibin A may be a better pre dictor of early-onset preeclampsia, which is associated with a higher mater nal and perinatal morbidity and mortality, than preeclampsia at or near ter m. Copyright (C) 2000 by the Society for Gynecologic Investigation.