The effect of maternal alcohol and drug abuse on first trimester screening analytes: a retrospective cohort study

被引:2
作者
Lehikoinen, Anni [1 ,2 ]
Voutilainen, Raimo [1 ,2 ]
Romppanen, Jarkko [3 ]
Heinonen, Seppo [4 ,5 ,6 ]
机构
[1] Kuopio Univ Hosp, Dept Pediat, POB 100, Kuopio 70029, Finland
[2] Univ Eastern Finland, Dept Pediat, POB 1627, FI-70211 Kuopio, Finland
[3] Eastern Finland Lab Ctr Joint Author Enterprise I, POB 1700, Kuopio 70211, Finland
[4] Helsinki Univ Hosp, Dept Obstet & Gynecol, POB 140, Helsinki 00029, Finland
[5] Univ Helsinki, Dept Obsteter & Gynecol, POB 63, Helsinki 00014, Finland
[6] Kuopio Univ Hosp, Dept Obstet & Gynecol, POB 100, Kuopio 70029, Finland
关键词
First trimester screening; PAPP-A; free beta-hCG; nuchal translucency; alcohol; smoking; small for gestational age; HUMAN CHORIONIC-GONADOTROPIN; PLASMA-PROTEIN-A; BIOCHEMICAL MARKERS; NUCHAL TRANSLUCENCY; PAPP-A; BETA; PREGNANCY; BIOMARKERS; EXPOSURE; ETHANOL;
D O I
10.1186/s12884-020-03171-9
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Background: The purpose of this study was to determine whether first trimester trisomy screening (FTS) parameters are affected by alcohol and drug use. Methods: A routine combined FTS including measurements of maternal serum levels of free beta-human chorionic gonadotropin subunit (free beta-hCG) and pregnancy-associated plasma protein A (PAPP-A) were measured at 9-11 weeks of gestation, and fetal nuchal translucency thickness (NTT) at 11-13 weeks of gestation. In total 544 women with singleton pregnancies [71 alcohol and drug abusers, 88 smokers, 168 non-smokers delivering a small for gestational age (SGA) child, and 217 unexposed control women] were assessed. Results: Free beta-hCG levels were higher in alcohol and drug abusing than in unexposed pregnant women [mean 1.5 vs. 1.2 multiples of medians (MoM); P=0.013]. However, stepwise multiple linear regression analyses suggested that smoking could explain increased free beta-hCG. Additionally, we observed lower PAPP-A levels in the smoking mothers (0.9 vs. 1.2 MoM; P=0.045) and in those giving birth to an SGA child compared to the controls (1.1 vs.. 1.2 MoM; P<0.001). Fetal NTT did not differ significantly between any of the groups. Conclusions: The present study shows increased free beta-hCG levels in alcohol and drug abusers, but maternal smoking may explain the result. Maternal serum PAPP-A levels were lower in smoking than non-smoking mothers, and in mothers delivering an SGA child. However, FTS parameters (PAPP-A, free beta-hCG and NTT) seem not to be applicable for the use as alcohol biomarkers because of their clear overlap between alcohol abusers and healthy controls.
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