Assessment of serum β‐<scp>hCG</scp> and lipid profile in early second trimester as predictors of hypertensive disorders of pregnancy

Revankar, Vijaya Manohar; Lavu, Narmada

doi:10.1002/ijgo.12225

“…Some authors reported that major decrease in PAPPA and PlGF levels occurs only in the second trimester, implying that measurements of these parameters in the first trimester may not be reliable enough (13). Contrary, in several studies biochemical markers such as Beta HCG and PlGF were significantly correlated only with early and not late onset GH/PE (5, 28). According to our study results, serum levels of PAPPA in the first as well as HCG and AFP in the second trimester of pregnancy were significantly higher in women who developed early or late onset GH/PE as well as placental abruption during pregnancy.…”

Section: Discussionmentioning

confidence: 60%

Biochemical Markers for Prediction of Hypertensive Disorders of Pregnancy

Belovic¹,

Plešinac

²

,

Dotlić

³

et al. 2019

Journal of Medical Biochemistry

View full text Add to dashboard Cite

SummaryBackground:Gestational hypertension (GH) and pre eclampsia (PE) are the most common gestational complications. Several placental biochemical markers are used to predict GH/PE, but with conflicting results.Methods:The study aim was to estimate the biochemical markers’ ability to predict hypertensive disorders in pregnancy. On the first ultrasonographic examination, 104 healthy pregnant women were recruited. At the regular pregnancy check-ups, BMI, blood pressure, occurrence of gestational hypertension (early or late onset), preeclampsia, eclampsia and other complications were recorded. Serum concentrations (in multiples of median – MoM) of human chorionic gonadotropin (HCG) and pregnancyassociated plasma protein A (PAPPA) were measured from the 11th to 14th gestational week, while HCG, alpha feto protein (AFP), estriol and inhibin were determined between the 16th and 19th gestational week.Results:Hypertensive disorders throughout pregnancy were diagnosed in 20.2% women. Early-onset GH was registered in 7 and PE in 6 patients, while 14 had late-onset GH and 10 additional women PE. There were no significant differences (p≥0.05) in biochemical markers concentrations between women with and without GH/PE. PAPPA levels in the first and HCG in the second trimester correlated with early and late GH/PE. Moreover, higher AFP concentrations were registered in women with preeclampsia signs/symptoms. According to ROC analysis, AFP>1.05 MoM properly identified 80% of GH/PE cases. Obtained models imply that HCG, PAPPA and AFP should be used for GH/PE prediction.Conclusions:Biochemical markers HCG, PAPPA and AFP could be useful in predicting gestational hypertension and preeclampsia. However, different markers should be used for early and late onset GH/PE.

show abstract

“…Serum β-hCG levels can reflect the functional status of the placenta. When placental ischemia and hypoxia happen, the secretion of β-hCG by trophoblast cells increases [13][14][15]. Placental function is directly related to the occurrence of various diseases during pregnancy and adverse pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Serum β-Human Chorionic Gonadotropin on Pregnancy Complications and Adverse Pregnancy Outcomes: A Systematic Review and Meta-Analysis

Huang¹,

Liu

²

,

Yang

³

et al. 2022

Computational and Mathematical Methods in Medicine

2

0

1

View full text Add to dashboard Cite

Background. The relationship among elevated serum β-human chorionic gonadotropin (β-hCG), the incidence of pregnancy complications, and adverse pregnancy outcomes has been controversial. Differences in study design, subject bias due to demographic characteristics, and differences in local medical levels could contribute to inconsistent results. Methods. Literature searches were performed in PubMed, EMBASE, Medline, Central, China National Knowledge Infrastructure (CNKI), Wanfang, and China Science Digital Library (CSDL) databases. Inclusion criteria were as follows: (1) research subjects were singleton pregnant women; (2) the study is identified as cohort study; (3) the subjects were assigned to the high β-hCG group and control group according to whether the exposure factors increased β-hCG in the second trimester; (4) the observed outcomes include at least pregnancy-induced hypertension (PIH), diabetes (gestational diabetes mellitus, GMD), preterm delivery (PD), and intrauterine growth restriction (IUGR); and (5) the odds ratio (OR) and 95% confidence interval (CI) of exposure factors are calculated based on literature dataset. To determine the risk bias of selected literatures, Newcastle-Ottawa scale was applied. The chi-square test was further used for heterogeneity analysis. If heterogeneity was identified, subgroup analyses were then performed for source investigation. Results. A total of 13 literatures were included and analyzed, including 67,355 pregnant women and 5980 pregnant women assigned to the high β-HCG group and 61,375 pregnant women to the control group. The incidence of PIH in the high β-HCG group was higher than that in the control group ( OR = 2.11 , 95% CI [1.90, 2.35], Z = 13.85 , P < 0.00001 ). There was no heterogeneity among literatures ( χ 2 = 8.53 , P = 0.38 , I 2 = 6 % ), and thus there is no identified publication bias ( P > 0.05 ). The incidence of preterm birth in the high β-HCG group was higher than that in the control group ( OR = 2.11 , 95% CI [1.90, 2.35], Z = 13.85 , P < 0.00001 ). The analysis suggested no heterogeneity among included literatures ( χ 2 = 11.78 , P = 0.11 , I 2 = 41 % ) and no publication bias ( P > 0.05 ). Higher incidence of abortion was observed in the high β-HCG group compared with the control group ( OR = 2.80 , 95% CI [1.92, 4.09], Z = 5.32 , P < 0.00001 ). There was no heterogeneity among literatures ( χ 2 = 3.43 , P = 0.33 , I 2 = 13 % ) and no publication bias ( P > 0.05 ). The incidence of gestational diabetes was higher in the high β-HCG group than in the control group ( OR = 2.15 , 95% CI [1.05, 4.40], Z = 2.09 , P = 0.04 ). Heterogeneity was identified among literatures ( χ 2 = 47.01 , P < 0.00001 , I 2 = 87 % ). Sensitivity analysis showed that the results were not robust, and there was no publication bias ( P > 0.05 ). Compared with control, the incidence of IGUR was higher in the high β-HCG group ( OR = 2.70 , 95% CI [1.75, 4.19], Z = 4.45 , P < 0.0001 ) with no heterogeneity among literatures ( χ 2 = 3.92 , P = 0.14 , I 2 = 49 % ) and no publication bias ( P > 0.05 ). Conclusion. High levels of β-hCG during pregnancy in singleton women are associated with a high incidence of pregnancy complications and adverse pregnancy outcomes. Pregnant women with high levels of β-hCG should be monitored more closely, followed up, and given timely medical interventions to reduce the incidence of pregnancy complications and adverse outcomes.

show abstract

“…In present study, we observed the sensitivity, specificity, positive predictive value and negative predictive value for β-hCG levels for >2MOM were 85.2%, 92.5%, 81.98% and 94.8% respectively. Chowdhary H et al [11] , Pawar P et al [9] , Revankar V M [13] , Soundararajan P et al [4] , Kulkarni N et al [7] , Mazhari F 3 had reported similar findings. In present study, the PIH patients cesarean was done in majority of the cases (77.8%) where as in normotensive patients cesarean was done in 52.0 % and the association was found to be statistically significant between hypertensive and normotensive patients (p< 0.05).…”

Section: Discussionmentioning

confidence: 71%

Role of serum beta human chorionic gonadotropin at 13-20 weeks of gestation as a predictor of hypertensive disorders of pregnancy

Singhal¹,

Tyagi²,

Maheshwari³

et al. 2020

Int. J. Clin. Obstet. Gynaecol.

0

View full text Add to dashboard Cite

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal morbidity and mortality worldwide. The objective of this study was to measure β-hCG during 13-20 weeks of gestation and compare the same between those who develop Hypertensive disorders of pregnancy with those who do not. Methods: A prospective observational study was carried out on 200 primigravida patients in their second trimester (13-20 weeks) attending the OPD in Muzaffarnagar Medical College. Serum β-hCG levels were estimated in all these patients by CLIA (chemiluminescent immune assay) technique. All pregnancies were followed up till delivery for the development of Hypertensive disorders of pregnancy. Results: Out of 200 patients, 27(13.5%) cases developed Pregnancy induced hypertension. Of those who developed PIH, 22(70.9%) were having β-hCG levels >2 MOM (P< 0.05). Absolute β-hCG levels (Mean ± SD) were also significantly higher (95963.0 ± 42337.64 V/S 40319.74 ± 10659.42; P< 0.05) in subjects who later developed PIH. Sensitivity, Specificity, Positive predictive value and Negative predictive value for β-hCG were 85.2%, 92.5%, 81.98% and 94.8% respectively. Conclusion: Serum β-hCG estimation at mid trimester (13-20 weeks) is a good predictor of PIH and higher levels of β-hCG are associated with increased severity of PIH.

show abstract

Assessment of serum β‐hCG and lipid profile in early second trimester as predictors of hypertensive disorders of pregnancy

Abstract: Serum β-hCG might be used as a predictor of hypertensive disorders that complicate pregnancy. Dyslipidemia was not found to be a useful marker.

Cited by 7 publications

References 13 publications

Biochemical Markers for Prediction of Hypertensive Disorders of Pregnancy

Biochemical Markers for Prediction of Hypertensive Disorders of Pregnancy

The Effect of Serum β-Human Chorionic Gonadotropin on Pregnancy Complications and Adverse Pregnancy Outcomes: A Systematic Review and Meta-Analysis

Role of serum beta human chorionic gonadotropin at 13-20 weeks of gestation as a predictor of hypertensive disorders of pregnancy

Contact Info

Product

Resources

About