Title

Maternal serum analytes as predictors of IUGR with different degrees of placental vascular dysfunction

Publication Date

2014

Journal Title

Prenat Diagn

Abstract

Objectives Our primary objective was to determine the association of maternal serum analytes in pregnancies complicated by intrauterine growth restriction (IUGR) stratified by umbilical artery (UA) Doppler versus pregnancies with appropriately grown for gestational age (AGA) and its potential use as screening model. Methods Retrospective cohort evaluating first and second trimester maternal serum aneuploidy screening markers in women complicated with IUGR [90 with absent or reversed end diastolic velocity (AREDV), 46 with UA systolic/ diastolic ratio >= 95th percentile and 215 with normal UA Doppler] versus 2590 women with AGA fetuses (control). Results Extreme levels of each analyte were significantly more common in the IUGR/AREDV group than in AGA group: inhibin A >97th percentile [>= 2.27 multiples of the median (MoM)], OR: 41 (95% CI: 21-80); unconjugated estriol(97th percentile (>= 1.88 MoM), OR: 15 (95% CI: 8.2-27); PAPP-A(97th percentile (>= 3.24 MoM), OR: 11.6 (95% CI: 4.2-32). In a subgroup of pregnancies in which all markers were evaluated on each patient, a combination of abnormal markers detected 73% (95% CI: 54-87%) of IUGR/AREDV fetuses. When maternal risk factors were included into the risk calculation, it increased to 91% (95% CI: 76-98%). Conclusions Abnormal maternal serum aneuploidy markers preferentially identify those pregnancies at greatest risk of IUGR with AREDV in the UA. (C) 2014 John Wiley & Sons, Ltd.

Volume Number

34

Issue Number

7

Pages

692-698

Document Type

Article

EPub Date

2014/03/29

Status

Faculty; Northwell Reseacher

Facility

School of Medicine; Northwell Health

Primary Department

Obstetrics and Gynecology

PMID

24677013

DOI

10.1002/pd.4369