the Forecast of Weekly β-HCG and Progesterone for Early Pregnancy

Abstract

Background: Serum beta human chorionic gonadotropin (β-HCG) and progesterone levels are both monitored to assess the status of early pregnancy. Deviations from the expected levels of these hormones may indicate abnormal pregnancy. However; the relationship between progesterone levels and the magnitude of weekly β-HCG increases, as well as their combined predictive value for pregnancy outcome, is still debated. This study evaluated the predictive value of weekly serum β-HCG multiplication and progesterone levels on early pregnancy outcomes. Methods: This retrospective study reviewed patients with pregnancy confirmed by β-HCG in our hospital. Weekly β-HCG and progesterone levels were analyzed and ultrasonography was performed as necessary to determine outcomes at 13 weeks gestation. Results: There were 277 viable intrauterine pregnancies, 102 spontaneous abortions, and 59 ectopic pregnancies. At weeks 5-8, β-HCG was multiplied by 6.76, 6.21, 2.11, and 0.68 respectively. Logit models were established with the logarithm of HCG (LHCG) and progesterone as independent variables to predict viable intrauterine pregnancy. The sensitivity, specificity, and overall accuracy for the models were 85.9% and 90.3%, 44.72% and 72%, and 70.77% and 83.6%, respectively. When progesterone was ≥10 ng/ml, the sensitivity and specificity for predicting viable pregnancy were 90.25% and 72.04%, respectively. When progesterone was <10 ng/ml, the sensitivity and specificity for predicting ectopic pregnancy and complete abortion were 94.2% and 81.57%, respectively. Progesterone values were significantly different for viable pregnancy, abortion, and ectopic pregnancy (p<0.0001). A joint progesterone and LHCG model to predict viable pregnancy had 88.8% sensitivity, 75.2% specificity, and 83.8% overall prediction accuracy. Conclusion: Weekly β-HCG multiplication and progesterone levels can predict early pregnancy outcomes individually or jointly.