Prediction of adverse pregnancy outcomes by extreme values of first trimester screening markers

Abstract

Background To determine the association between extreme values of first trimester markers and adverse pregnancy outcomes.

Methods A retrospective cohort study of 916 women who underwent first-trimester combined screening during 2015 was performed. Extreme values of NT, pregnancy-associated plasma protein-A (PAPP-A) and free -hCG, and their association with adverse pregnancy outcomes were analyzed.

Results Low PAPP-A (<10th percentile) was associated with an increased risk for preeclampsia (adjusted odds ratio (AOR) 4.13), fetal growth restriction (AOR 3.94) and abruptio placentae (AOR 52.63). Abnormally low or high free -hCG, high PAPP-A or increased NT was not associated with an increased risk for adverse outcomes.

Discussion PAPP-A <10th percentile could be associated with an increased risk for adverse outcomes. However, the majority of patients with these events do not have abnormal PAPP-A and few patients with PAPP-A <10th percentile will have an adverse outcome.