Decreased First-trimester Maternal Serum Free-beta Subunit Human Chorionic Gonadotropin and Preterm Birth in Twin Gestations

作者：Laughon S Katherine; Rebarber Andrei; Rolnitzky Linda; Fink Lois; Saltzman Daniel H

来源：American Journal of Perinatology, 2009, 26(7): 491-494.

DOI：10.1055/s-0029-1214250

• Free beta hCG
• PAPP-A
• preterm labor
• preterm birth
• twin gestation

We investigated whether abnormal concentrations of first-trimester free-beta subunit human chorionic gonadotropin (f ss hCG) and pregnancy-associated plasma protein A (PAPP-A) are associated with preterm delivery in twin gestations. This was a hospital-based, retrospective study of 70 twin gestations between 111/7 and 136/7 weeks' gestation undergoing first-trimester screening. Free beta hCG and PAPP-A multiples of the median were determined by our laboratory standards. Odds ratios (ORs) were estimated that compared the prevalence of very preterm (< 32 weeks), preterm (>= 32 and < 37 weeks), and term birth (>= 37 weeks) between the lower and higher percentile groups for each ana,lyte. F ss hCG levels < 25th percentile were associated with very preterm birth < 32 weeks' gestation (OR 5.10; 95% confidence interval [CI]: 1.19 to 21.95), but not with preterm birth >= 32 and < 37 weeks' gestation (OR 0.50; 95% CI: 0.16 to 1.61). PAPP-A was not associated with very preterm (OR 2.95; 95% Cl: 0.69 to 12.60) or preterm birth (OR 0.71; 95% CI: 0.23 to 2.21). Low first-trimester f ss hCG was a strong predictor for very preterm birth in twin gestations. Low first-trimester PAPP-A was associated with a trend in increased risk of very preterm birth.

• 出版日期2009-8