Perinatal outcome of fetuses with high (>4.0 MoMs) first-trimester free beta-hCG levels
Objective: To analyze the perinatal outcome of fetuses with high first-trimester free beta human chorionic gonadotrophin (b-hCG) levels and compare it with controls.
Method: Prospectively collected data from 113 fetuses with free b-hCG levels >4.0 MoMs and 3176 controls were analyzed to compare the rates of chromosomal abnormalities, structural defects, preeclampsia, hypertension, abruption, miscarriage, low birthweight, intrauterine or neonatal death, gestational diabetes and NICU admissions. Odds ratios with 95% confidence intervals (CIs) were calculated.
Results: Fetuses with free b-hCG levels >4.0 MoMs had a 8.8% (95% CI 4.8-15.3) rate of chromosomal abnormalities, mostly Down syndrome. The prevalence of preeclampsia in this group was 3.8% (95% CI 1.5-9.5), significantly higher (OR 3.1, 95% CI 1.1-8.9) compared to controls. There were no significant differences in any of the other outcomes. There were no cases of intrauterine or neonatal death.
Conclusion: The main concern in fetuses with high first-trimester free b-hCG levels is increased risk for chromosomal abnormalities. Fetuses with a normal karyotype may be at increased risk for preeclampsia.