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Temporal effects of maternal and pregnancy characteristics on serum PAPP-A and free β-hCG at 7-14 weeks' gestation

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Objective: Investigate gestational age dependent effects of racial origin, smoking status and mode of conception on maternal serum levels of free ß-human chorionic gonadotropin (β-hCG) and pregnancy associated plasma protein-A (PAPP-A) at 7-14 weeks' gestation. Methods: Data arise from prospective first-trimester combined screening for aneuploidies in singleton pregnancies, with serum free ß-hCG and PAPP-A measured at 7(+1) -14(+3) weeks' gestation. We include 27,908 pregnancies from three centres in the UK and 125,461 pregnancies from 22 centres in Denmark with normal fetal karyotype or birth of a phenotypically normal neonate. Multiple regression modelling of log(10) -transformed marker concentrations was used to produce log(10) multiple of the median (MoM) values for free β-hCG and PAPP-A and to examine pregnancy characteristics that have significant effects on marker concentrations. Results: Serum free ß-hCG and PAPP-A concentrations were significantly affected by gestational age, maternal weight, racial origin, parity, smoking and mode of conception. There were significant gestational age dependent effects of Afro-Caribbean race, smoking and IVF conception on PAPP-A and free ß-hCG levels. In women of Afro-Caribbean race there was a weekly increase in PAPP-A of 5.3% and in free ß-hCG of 1.8%. In smokers there was a weekly decrease in PAPP-A of 2.4% and in free β-hCG of 1.6%. In IVF conceptions there was a weekly increase in PAPP-A of 4.5% and in free ß-hCG of 4.6%. Conclusions: Serum free ß-hCG and PAPP-A concentrations at 7-14 weeks are affected by several pregnancy characteristics. The effects of Afro-Caribbean race, smoking and IVF conception change with gestational age. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Original languageEnglish
JournalUltrasound in Obstetrics & Gynecology
Volume41
Issue number1
Pages (from-to)33
Number of pages39
ISSN0960-7692
DOIs
Publication statusPublished - 2013

Bibliographical note

S. Ball1,*, C. Ekelund2, D. Wright1, I. Kirkegaard3, P. Nørgaard4, O. B. Petersen3, A. Tabor2, the Danish Fetal Medicine Study Group
Article first published online: 4 DEC 2012

DOI: 10.1002/uog.11209

Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Issue Ultrasound in Obstetrics & Gynecology
Ultrasound in Obstetrics & Gynecology
Volume 41, Issue 1, pages 33–39, January 2013
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Author Information
1Centre for Health and Environmental Statistics, Plymouth University, Plymouth, UK
2Department of Fetal Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
3Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
4Department of Obstetrics and Gynecology, Hvidovre University Hospital, Hvidovre, Denmark
*Correspondence to: Dr S. Ball, Centre for Health and Environmental Statistics, Tamar Science Park,1 Davy Road,Plymouth PL6 8BX, UK (e-mail: susan.ball2@plymouth.ac.uk)

ID: 36409741