Analysis of mid-trimester corticotrophin-releasing hormone and alpha-fetoprotein concentrations for predicting pre-eclampsia

The aims of this study were firstly to examine if corticotrophin-releasing hormone (CRH) concentrations in maternal plasma were significantly elevated in Chinese pregnancies complicated by pre-eclampsia, secondly to assess if this elevation could be detected in the midtrimester before onset of clini cal signs of the disease, and thirdly to evaluate the performance of using maternal CRH and/or alpha-fetoprotein (AFP) concentrations in the midtrimes ter for prediction of pre-eclampsia, The first part of this study was teste d in a cohort of 39 subjects. The CRH concentrations were significantly ele vated in pregnant women complicated by pre-eclampsia, The second and third parts of the study involved a different cohort of 1021 subjects. Both CRH a nd AFP concentrations in the midtrimester were significantly elevated in th ose who subsequently developed pre-eclampsia, However, when used for predic tion of pre-eclampsia, neither the CRH nor AFP concentrations alone in the mid-trimester had strong predictive value. Although the combination of both tests improved the detection rate compared to the use of CRH alone, the sm all increase in the likelihood ratio from 1.9 to 2.6 did not suggest that t he combination would be of great clinical value.