Document Detail

First-trimester biochemical markers of aneuploidy and the prediction of small-for-gestational age fetuses.
MedLine Citation:
PMID:  17999381     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To examine the clinical utility of the first-trimester biochemical markers of aneuploidy in their ability to predict subsequent delivery of a small-for-gestational age (SGA) infant. METHODS: We examined singleton pregnancies with no chromosomal abnormality and with complete outcome data that had undergone screening for trisomy 21 by a combination of fetal nuchal translucency (NT) thickness and maternal serum free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at 11 + 0 and 13 + 6 weeks' gestation. The biochemical markers were converted to multiples of the expected normal median (MoM) for a pregnancy of the same gestation. The association between free beta-hCG and PAPP-A and the incidence of SGA were assessed by comparing the relative incidence at MoM cut-offs and birth-weight centile cut-offs. At various marker levels the likelihood ratios (LR) for SGA were also calculated after excluding other adverse pregnancy complications. RESULTS: There were 46,262 pregnancies resulting in live births with birth weight at or above the 10(th) centile, and 3,539 below the 10(th) centile for gestation (SGA). There was a significant inverse association between the risk for SGA and maternal serum PAPP-A MoM but not free beta-hCG MoM. At the 5(th) centile of the normal outcome group for PAPP-A (0.415 MoM) the odds ratios for SGA below the 10(th), 5(th) and 3(rd) centiles of normal were 2.70, 3.21 and 3.66 and the respective detection rates for SGA were 12.0%, 14.0% and 16.0%. CONCLUSIONS: Low levels of maternal serum PAPP-A are associated, in the absence of an abnormal karyotype, with an increased risk for subsequent delivery of an SGA infant.
K Spencer; N J Cowans; K Avgidou; F Molina; K H Nicolaides
Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  31     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-27     Completed Date:  2008-05-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  15-9     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd.
Prenatal Screening Unit, Clinical Biochemistry Department, Harold Wood Hospital, Romford, Essex, UK.
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MeSH Terms
Biological Markers / metabolism
Chorionic Gonadotropin, beta Subunit, Human / metabolism*
Fetal Growth Retardation / diagnosis
Infant, Newborn
Infant, Small for Gestational Age*
Nuchal Translucency Measurement / methods
Pregnancy Outcome
Pregnancy Trimester, First / metabolism
Pregnancy-Associated Plasma Protein-A / metabolism*
Prenatal Diagnosis / methods*
Sensitivity and Specificity
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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