Predictive Value of Free β-hCG Multiple of the Median for Women with Preeclampsia

Abstract

Background: Preeclampsia (PE) is relatively common and is unpredictable in its onset and progression. Aims: We investigated the clinical value of using the multiple of the median (MoM) of free β-human chorionic gonadotropin (β-hCG) concentrations in women with normal pregnancy and PE. Methods: This study was based on a dataset available from published studies, and the relevant studies were retrieved from multiple electronic databases. Data were extracted from case-control studies; a random-effects model was employed, and standardized mean difference and 95% confidence intervals were calculated. Twelve case-control studies (eleven English-based articles and one Chinese-based article) were analyzed in the current meta-analysis and included 702 patients with PE and 8,233 women with normal pregnancies. Results: Statistical analysis revealed a higher MoM of β-hCG serum levels in patients with PE. Ethnicity subgroup analysis showed that the MoM of serum β-hCG levels was significantly higher in women with PE in both Asian and Caucasian populations. Conclusion: The MoM of β-hCG serum levels was significantly increased in women with PE compared to women with normal pregnancies. Screening for serum β-hCG MoM levels will be helpful in the early identification of pregnancies at risk of developing PE.

Prediction of pre‐eclampsia: review of reviews

“…Of the 2444 citations identified, 126 systematic reviews were included in this review. Figure provides details of the review identification and selection process.…”

“…The most commonly reported clinical characteristics included body mass index (BMI) or weight (n = 9 reviews) 58,69,90,107,113,117,124,133,139 , maternal age (n = 2) 69,133 , parity (n = 2) 69,133 , blood pressure (n = 5) 47,57,61,69,90 and oocyte donation (n = 3) 42,86,106 , and six reviews reported on multiple clinical characteristics 23,61,69,89,107,133 . Of the biochemical markers, the following were most commonly studied: pregnancy-associated plasma protein-A (PAPP-A) (n = 7) 24,43,61,89,93,109,110 , placental growth factor (PlGF) (n = 7) 21,23,24,43,88,89,93 and β-human chorionic gonadotropin (β-hCG) (n = 7) 43,61,89,93,104,107,110 . Over 30 additional biomarkers were reviewed.…”

Human chorionic gonadotropin and risk of pre‐eclampsia: prospective population‐based cohort study

“…Although the exact mechanism remains to be elucidated, abnormal placentation and a subsequent hyperinflammatory response, characterized by a disturbance in pro-and anti-angiogenic factors, play a major role [2][3][4] . Multiple studies have investigated the association of hCG with the risk of pre-eclampsia, comprising data on different hCG isoforms [15][16][17][18][19][20]27 . Although in early and in late pregnancy high total hCG and β-hCG concentrations are suggested as a marker of (subsequent) pre-eclampsia [15][16][17][18] , some studies report an association of low early-pregnancy β-hCG 19,27 and hyperglycosylated hCG with pre-eclampsia 20 .…”

“…Multiple studies have investigated the association of hCG with the risk of pre-eclampsia, comprising data on different hCG isoforms [15][16][17][18][19][20]27 . Although in early and in late pregnancy high total hCG and β-hCG concentrations are suggested as a marker of (subsequent) pre-eclampsia [15][16][17][18] , some studies report an association of low early-pregnancy β-hCG 19,27 and hyperglycosylated hCG with pre-eclampsia 20 . The interpretation and comparison of these studies are hampered by the differences in hCG measurement.…”

“…hCG also regulates placental development, angiogenesis and vasculogenesis, partially via effects on VEGFs [10][11][12][13][14] . Several studies suggest that high and/or low hCG concentration is a marker of subsequent clinical manifestation of pre-eclampsia [15][16][17][18] . However, considerable between-study discrepancies exist, such as the gestational age at hCG measurement, the specific hCG isoform that was assessed and the specific pre-eclampsia phenotype analyzed [15][16][17][18][19][20] .…”