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Volume 6, Issue 1 (Winter 2021)                   J Obstet Gynecol Cancer Res 2021, 6(1): 22-28 | Back to browse issues page


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Taghavipour M, Galini-Moghaddam T, Mousavi S J. First and Second-Trimester Maternal Serum Analytes for the Prediction of Adverse Pregnancy Outcomes. J Obstet Gynecol Cancer Res. 2021; 6 (1) :22-28
URL: http://jogcr.com/article-1-325-en.html
1- MD, Obstetrics and Gynecology Specialist, Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
2- MD, Obstetrics and Gynecology Specialist, Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran , tgmoghaddam@gmail.com
3- MD, Community Medicine Specialist, Department of Community Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Abstract:   (146 Views)
Background and Objectives: Maternal serum levels of the first- and second-trimester markers for aneuploidy have been revealed to be associated with adverse pregnancy outcomes in the absence of neural tube defects or aneuploidy. This finding can guide clinicans for early diagnosis and management of such outcomes. However, previous finding are conflicting in this regard. Therefore, this study evaluated the detection of adverse pregnancy outcomes by first- and second-trimester serum screening analytes.
Methods & Materials: We prospectively recruited 972 females who underwent first and second-trimester aneuploidy screening. We gathered information on maternal demographic characteristics and serum biomarkers (free B-hCG and PAPP-A for the first-trimester; AFP, Β-hCG, Inhibin-A, and unconjugated estradiol for second-trimester). At the end of the study, adverse pregnancy outcome was recorded.
Results: Abnormal screening results were reported in 34 (3.5%) patients. Two groups were significantly different in maternal age, BMI, and gestational period (P=0.017, 0.003 and 0.021, respectively). Among the measured adverse outcomes, preeclampsia was significantly more prevalent in the case group (P<0.0001). Abnormal levels of Inhibin-A is associated with the incidence of preeclampsia (RR: 29.87, CI: 13.22-67.49, P<0.0001). Additionally, patients with an abnormal level of Inhibin-A had a shorter gestational period (255.5 ± 24.53 vs. 264.79 ± 8.99, P=0.006). Likewise, patients with an abnormal level of maternal serum alpha-fetoprotein (MSAFP) had a shorter gestational period (252.0 ± 29.3 vs. 264.8 ± 8.93, P=0.001).
Conclusion: First- and second-trimester maternal serum biomarkers could provide a possible screening tool for early detection of preeclampsia.
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Systematic Review: Original Research | Subject: Maternal Fetal Medicine
Received: 2020/10/16 | Accepted: 2020/12/20 | Published: 2021/01/10

References
1. Carlson LM, Vora NL. Prenatal Diagnosis: Screening and Diagnostic Tools. Obstetrics and gynecology clinics of North America. 2017;44(2):245-56. [DOI:10.1016/j.ogc.2017.02.004] [PMID] [PMCID]
2. Cuckle H, Maymon R. Development of prenatal screening--A historical overview. Semin Perinatol. 2016;40(1):12-22. [DOI:10.1053/j.semperi.2015.11.003] [PMID]
3. Practice Bulletin No. 162: Prenatal Diagnostic Testing for Genetic Disorders. Obstet Gynecol. 2016;127(5):e108-22. [DOI:10.1097/AOG.0000000000001405] [PMID]
4. Shirazi M, Sarmadi S, Niromanesh S, Rahimi Sharbaf F, Sahebdel B, Golshahi F, et al. Assessment of the Sensitivity and Specificity of Screening Tests Performed in the First and Second Trimester in the Pregnant Women. Journal of Obstetrics, Gynecology and Cancer Research. 2019;4(1):12-5. [DOI:10.30699/jogcr.4.1.12]
5. Dugoff L. First- and second-trimester maternal serum markers for aneuploidy and adverse obstetric outcomes. Obstet Gynecol. 2010;115(5):1052-61. [DOI:10.1097/AOG.0b013e3181da93da] [PMID]
6. Dugoff L, Hobbins JC, Malone FD, Porter TF, Luthy D, Comstock CH, et al. First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: a population-based screening study (the FASTER Trial). Am J Obstet Gynecol. 2004;191(4):1446-51. [DOI:10.1016/j.ajog.2004.06.052] [PMID]
7. Dugoff L, Hobbins JC, Malone FD, Vidaver J, Sullivan L, Canick JA, et al. Quad screen as a predictor of adverse pregnancy outcome. Obstet Gynecol. 2005;106(2):260-7. [DOI:10.1097/01.AOG.0000172419.37410.eb] [PMID]
8. Huang T, Hoffman B, Meschino W, Kingdom J, Okun N. Prediction of adverse pregnancy outcomes by combinations of first and second trimester biochemistry markers used in the routine prenatal screening of Down syndrome. Prenat Diagn. 2010;30(5):471-7. [DOI:10.1002/pd.4090]
9. Krantz D, Goetzl L, Simpson JL, Thom E, Zachary J, Hallahan TW, et al. Association of extreme first-trimester free human chorionic gonadotropin-beta, pregnancy-associated plasma protein A, and nuchal translucency with intrauterine growth restriction and other adverse pregnancy outcomes. Am J Obstet Gynecol. 2004;191(4):1452-8. [DOI:10.1016/j.ajog.2004.05.068] [PMID]
10. Milunsky A, Nebiolo L. Maternal serum triple analyte screening and adverse pregnancy outcome. Fetal Diagn Ther. 1996;11(4):249-53. [DOI:10.1159/000264310] [PMID]
11. Spencer K. Second-trimester prenatal screening for Down syndrome and the relationship of maternal serum biochemical markers to pregnancy complications with adverse outcome. Prenat Diagn. 2000;20(8):652-6. https://doi.org/10.1002/1097-0223(200008)20:8<652::AID-PD882>3.0.CO;2-6 [DOI:10.1002/1097-0223(200008)20:83.0.CO;2-6]
12. Gagnon A, Wilson RD. Obstetrical complications associated with abnormal maternal serum markers analytes. J Obstet Gynaecol Can. 2008;30(10):918-32. [DOI:10.1016/S1701-2163(16)32973-5]
13. Goetzinger KR, Odibo AO. Screening for abnormal placentation and adverse pregnancy outcomes with maternal serum biomarkers in the second trimester. Prenat Diagn. 2014;34(7):635-41. [DOI:10.1002/pd.4370] [PMID]
14. Goetzl L. Adverse pregnancy outcomes after abnormal first-trimester screening for aneuploidy. Clin Lab Med. 2010;30(3):613-28. [DOI:10.1016/j.cll.2010.04.003] [PMID] [PMCID]
15. Hui D, Okun N, Murphy K, Kingdom J, Uleryk E, Shah PS. Combinations of maternal serum markers to predict preeclampsia, small for gestational age, and stillbirth: a systematic review. J Obstet Gynaecol Can. 2012;34(2):142-53. [DOI:10.1016/S1701-2163(16)35157-X]
16. Kuc S, Wortelboer EJ, van Rijn BB, Franx A, Visser GH, Schielen PC. Evaluation of 7 serum biomarkers and uterine artery Doppler ultrasound for first-trimester prediction of preeclampsia: a systematic review. Obstet Gynecol Surv. 2011;66(4):225-39. [DOI:10.1097/OGX.0b013e3182227027] [PMID]
17. Morris RK, Cnossen JS, Langejans M, Robson SC, Kleijnen J, Ter Riet G, et al. Serum screening with Down's syndrome markers to predict pre-eclampsia and small for gestational age: systematic review and meta-analysis. BMC Pregnancy Childbirth. 2008;8:33. [DOI:10.1186/1471-2393-8-33] [PMID] [PMCID]
18. Yu N, Cui H, Chen X, Chang Y. First trimester maternal serum analytes and second trimester uterine artery Doppler in the prediction of preeclampsia and fetal growth restriction. Taiwan J Obstet Gynecol. 2017;56(3):358-61. [DOI:10.1016/j.tjog.2017.01.009] [PMID]
19. Zhong Y, Zhu F, Ding Y. Serum screening in first trimester to predict pre-eclampsia, small for gestational age and preterm delivery: systematic review and meta-analysis. BMC Pregnancy Childbirth. 2015;15:191. [DOI:10.1186/s12884-015-0608-y] [PMID] [PMCID]
20. Shirazi M, Rabiei M, Rahimi F, Niroomanesh S, Golshahi F, Eftekhar Yazdi M. Does Chorionic Villus Sampling Increase the Risk of Preeclampsia or Gestational Hypertension? International journal of preventive medicine. 2019;10:24-. [DOI:10.4103/ijpvm.IJPVM_83_16] [PMID] [PMCID]
21. Askie LM, Duley L, Henderson-Smart DJ, Stewart LA. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data. Lancet. 2007;369(9575):1791-8. [DOI:10.1016/S0140-6736(07)60712-0]
22. Bujold E, Roberge S, Lacasse Y, Bureau M, Audibert F, Marcoux S, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010;116(2 Pt 1):402-14. [DOI:10.1097/AOG.0b013e3181e9322a] [PMID]
23. Roberge S, Nicolaides KH, Demers S, Villa P, Bujold E. Prevention of perinatal death and adverse perinatal outcome using low-dose aspirin: a meta-analysis. Ultrasound Obstet Gynecol. 2013;41(5):491-9. [DOI:10.1002/uog.12421] [PMID]
24. Roberge S, Villa P, Nicolaides K, Giguere Y, Vainio M, Bakthi A, et al. Early administration of low-dose aspirin for the prevention of preterm and term preeclampsia: a systematic review and meta-analysis. Fetal Diagn Ther. 2012;31(3):141-6. [DOI:10.1159/000336662] [PMID]
25. Roberge S, Nicolaides K, Demers S, Hyett J, Chaillet N, Bujold E. The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis. Am J Obstet Gynecol. 2017;216(2):110-20.e6. [DOI:10.1016/j.ajog.2016.09.076] [PMID]
26. Roberge S, Bujold E, Nicolaides KH. Meta-analysis on the effect of aspirin use for prevention of preeclampsia on placental abruption and antepartum hemorrhage. Am J Obstet Gynecol. 2018;218(5):483-9. [DOI:10.1016/j.ajog.2017.12.238] [PMID]
27. Conde-Agudelo A, Romero R, Nicolaides K, Chaiworapongsa T, O'Brien JM, Cetingoz E, et al. Vaginal progesterone vs. cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix, previous preterm birth, and singleton gestation: a systematic review and indirect comparison metaanalysis. Am J Obstet Gynecol. 2013;208(1):42.e1-.e18. [DOI:10.1016/j.ajog.2012.10.877] [PMID] [PMCID]
28. Farmer DL, Thom EA, Brock JW, 3rd, Burrows PK, Johnson MP, Howell LJ, et al. The Management of Myelomeningocele Study: full cohort 30-month pediatric outcomes. Am J Obstet Gynecol. 2018;218(2):256.e1-.e13. [DOI:10.1016/j.ajog.2017.12.001] [PMID] [PMCID]
29. Buke B, Akkaya H, Demir S, Sagol S, Simsek D, Basol G, et al. Relationship between first trimester aneuploidy screening test serum analytes and placenta accreta. J Matern Fetal Neonatal Med. 2018;31(1):59-62. [DOI:10.1080/14767058.2016.1275546] [PMID]
30. Thompson O, Otigbah C, Nnochiri A, Sumithran E, Spencer K. First trimester maternal serum biochemical markers of aneuploidy in pregnancies with abnormally invasive placentation. Bjog. 2015;122(10):1370-6. [DOI:10.1111/1471-0528.13298] [PMID]
31. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-31.
32. Mahboobeh S, Mona M, Mahsa G. Complications, Indications and Results of Two Screening Methods: Amniocentesis and Chorionic Villus Sampling. Academic Journal of Surgery. 2015;2(1-2).
33. Shirazi M, Azadi F, Shariat M, Niromanesh S, Shirazi M. Effectiveness of stress management training on stress reduction in pregnant women. Tehran University Medical Journal. 2016;74(7):493-9.
34. Richards DS. Prenatal Ultrasound to Detect Fetal Anomalies. NeoReviews. 2012;13(1):e9-e19. [DOI:10.1542/neo.13-1-e9]
35. Niromanesh S, Mousavi Darzikolaei N, Rahimi-Shaarbaf F, Shirazi M. Pregnancy outcome in amniocentesis and chorionic villous sampling: ten- year report. Tehran University Medical Journal. 2016;74(6):400-7.
36. Shirazi M, Pooransari P, Rahimi Sharbaf F, Niromanesh SH, Sahebdel B, Shariat M, et al. Correlation of Maternal Stress Because of Positive Aneuploidy Screening Serum Analytes and Uterine Arteries' Doppler Ultrasound Index: A Prospective Cohort Study. Int J Fertil Steril. 2019;12(4):329-34.
37. Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutrition reviews. 2013;71 Suppl 1(0 1):S18-S25. [DOI:10.1111/nure.12055] [PMID] [PMCID]
38. Yazdani S, Rouholahnejad R, Asnafi N, Sharbatdaran M, Zakershob M, Bouzari Z. Correlation of pregnancy outcome with quadruple screening test at second trimester. Medical journal of the Islamic Republic of Iran. 2015;29:281-.
39. Feyzbakhsh S, Mozaffari R, Tajik A, Zafarnia M, Fardmanesh A. Triple test and pregnancy outcome association. Academic Research International. 2013;4(1):368.
40. Broumand F, Lak SS, Nemati F, Mazidi A. A study of the diagnostic value of Inhibin A Tests for occurrence of preeclampsia in pregnant women. Electronic physician. 2018;10(1):6186-92. [DOI:10.19082/6186] [PMID] [PMCID]
41. Olsen RN, Woelkers D, Dunsmoor-Su R, Lacoursiere DY. Abnormal second-trimester serum analytes are more predictive of preterm preeclampsia. Am J Obstet Gynecol. 2012;207(3):228.e1-7. [DOI:10.1016/j.ajog.2012.06.006] [PMID]
42. Ree PH, Hahn WB, Chang SW, Jung SH, Kang JH, Cha DH, et al. Early detection of preeclampsia using inhibin a and other second-trimester serum markers. Fetal Diagn Ther. 2011;29(4):280-6. [DOI:10.1159/000322742] [PMID]
43. Yu J, Shixia CZ, Wu Y, Duan T. Inhibin A, activin A, placental growth factor and uterine artery Doppler pulsatility index in the prediction of pre-eclampsia. Ultrasound Obstet Gynecol. 2011;37(5):528-33. [DOI:10.1002/uog.8800] [PMID]
44. Luisi S, Florio P, Reis FM, Petraglia F. Inhibins in female and male reproductive physiology: role in gametogenesis, conception, implantation and early pregnancy. Hum Reprod Update. 2005;11(2):123-35. [DOI:10.1093/humupd/dmh057] [PMID]

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