MATERNAL SERUM CONCENTRATIONS OF HUMAN PLACENTAL-LACTOGEN, ESTRADIOL AND PREGNANCY-SPECIFIC BETA(1)-GLYCOPROTEIN AND FETAL GROWTH-RETARDATION

Background. To determine if maternal serum levels of human placental l actogen (hPL), estradiol, and pregnancy-specific beta(1)-glycoprotein (SP1) measured at approximately 18 weeks' gestation were associated wi th fetal growth retardation (FGR) in infants delivered at or after 37 weeks. Method's. Serum samples were obtained at a mean of 18 weeks' ge stational age from 200 multiparous women with risk factors for FGR. Ma ternal serum concentrations of hPL, estradiol and SP1 were correlated with FGR. Results. A total of 59 (29.5%) of the 200 infants were diagn osed postnatally with FGR. There were no significant differences in th e prevalence of FGR among the lowest quartiles of estradiol, hPL or SP 1. However, pregnancies in the highest quartile of estradiol levels at 18 weeks' (>580 pg/ml) were associated with a significantly lower ris k of FGR than those in the lower three quartiles, 8 out of 50 (16%) vs 51 of 150 (34%) (p = <0.05). The prevalence of FGR associated with th e highest quartile of hPL (>1.73 mu g/ml) was 12.2% compared to 35% in the lower three quartiles (p = 0.025) and the prevalence of FGR assoc iated with the highest quartile of SP1 (>43 ng/ml) was 14% compared to 34.7% in the lower three quartiles (p = 0.018). Only one out of 21 in fants (4.5%) whose mothers had each value in the highest quartile of h PL, estradiol, and SP1 was diagnosed with FGR compared to 58 out of 17 8 (32.6%) of the remaining infants (p = 0.007). Conclusions. In pregna ncies of women at high risk for FGR, higher levels of estradiol, hPL, and SP1 at 18 weeks are associated with a decreased prevalence of FGR. This finding indicates that high levels of these hormones are related to a lower risk of FGR, but that low levels do not predict FGR.