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)

Objective: The purpose of this study was to determine whether maternal serum levels of pregnancy-associated plasma protein A, free-beta subunit human chorionic gonadotropin, or nuchal translucency size are associated with obstetric complications. Study design: Data were obtained from the First and Second Trimester Evaluation of Risk trial. Pregnancy-associated plasma protein A and free-beta subunit human chorionic gonadotropin levels were analyzed, and nuchal translucency was measured between 10 weeks 3 days and 13 weeks 6 days of gestation in 34,271 pregnancies. Results: Women with pregnancy-associated plasma protein A of less than or equal to5th percentile were significantly more likely to experience spontaneous fetal loss at less than or equal to24 weeks of gestation, low birth weight, preeclampsia, gestational hypertension, preterm birth (P < .001) and stillbirth, preterm premature rupture of membranes, and placental abruption (P < .02). Nuchal translucency at 99th percentile and free-beta subunit human chorionic gonadotropin at less than or equal to1st percentile were associated with an increased risk of spontaneous loss at less than or equal to24 weeks of gestation (adjusted odds ratios, 3.90, 3.62, respectively; P < .001). Conclusion: Low pregnancy-associated plasma protein A levels in the first trimester were associated strongly with a number of adverse pregnancy outcomes. Low free-beta subunit human chorionic gonadotropin levels and large nuchal translucency were both associated with early fetal loss. (C) 2004 Elsevier Inc. All rights reserved.