Elevated maternal serum hCG in the second trimester increases prematurity rate and need for neonatal intensive care in primiparous preeclamptic pregnancies
A. Heikkila et al., Elevated maternal serum hCG in the second trimester increases prematurity rate and need for neonatal intensive care in primiparous preeclamptic pregnancies, HYPERTENS P, 20(1), 2001, pp. 99-106
Citations number
17
Categorie Soggetti
Reproductive Medicine","Cardiovascular & Hematology Research
Objective. This study was designed to investigate the association between t
he serum concentrations of maternal second trimester human chorionic gonado
tropin (hCG) and the severity of preeclampsia.
Methods. At Kuopio University Hospital. a total of 487 preeclamptic primipa
ras had undergone maternal serum screening for Down's syndrome between Janu
ary 1993 and December 1998. Of these, 37 women had unexplained elevated ser
um hCG concentrations [>2.5 multiples of the median (MoM)], whereas the rem
aining 450 preeclamptic women had normal hCG results. Pregnancy characteris
tics and outcome measures in these groups were evaluated using logistic reg
ression.
Results. Elevated midtrimester hCG concentrations were associated with high
er rates of low-birth-weight infants, preterm delivery, and need for neonat
al intensive care. The adjusted odds ratios was 2.11 [95% confidence interv
al (CI): 1.03-4.32], 2.08 (95% CI: 1.10-4.30), and 2.27 (95% CI: 1.14-4.51)
, respectively.
Conclusions. In primiparous preeclamptic pregnancies, an elevated maternal
serum hCG concentration is a marker of early-onset and severe disease with
significant maternal and perinatal morbidity. This finding, in turn, reinfo
rces the association between elevated hCG concentrations and placental dama
ge in early pregnancy. Elevated maternal serum hCG levels identify a subgro
up of preeclamptic patients who deserve more intensive observation.