An association between elevated second-trimester human chorionic gonadotropin and subsequent preeclampsia

Park, Mi Hae; Ahn, Jung Ja

Abstract

OBJECTIVES
The purpose of this investigation was to determine whether women with unexplained elevations of maternal serum human chorionic gonadotropin(hCG) at 14-20weeks gestation are at incresed risk for poor pregnancy outcomes. METHODS: 661 pregnant women undergoing second trimester triple marker screening test for Down syndrome and neural tube defect and delivered at our hospital were reviewed. Of 656 pregnancies that did not have maternal serum alpha feto-protein> or =2.5 multiples of the median(MoM), risk for poor pregnancy outcomes include to preeclampsia, preterm delivery, preterm rupture of membrane(PROM), small for gestational age(SGA) and fetal distress was evaluated in women with elevated hCG(> or =2.0 MoM) compared with women without elevated hCG(<2.0 MoM). RESULTS: Pregnancies with elevated hCG levels were at increased risk for preeclampsia (risk ratio 3.4, 95% confidence interval 1.5-7.6) but elevated hCG levels were not significantly associated with preterm delivery, PROM, and SGA and fetal ditress independent with preeclampsia. CONCLUSION: Pregnancies with elevated second-trimester hCG appear to be at higher risk of subsequent preeclampsia and this finding supports the theory that placental vascular changes that ultimately lead to preeclampsia begin at least by the second trimester. But further studies must be to determine how such information can be used to improve pregnany outcome.