First trimester maternal serum PAPP-A and free β-HCG levels in hyperemesis gravidarum

Prenat Diagn. 2011 May;31(5):450-3. doi: 10.1002/pd.2715. Epub 2011 Feb 28.

Abstract

Objective: To evaluate whether hyperemesis gravidarum (HG) affects first-trimester maternal serum PAPP-A and free β-hCG levels.

Method: An observational study was conducted in 115 cases of HG and 110 control pregnancies who attended the first-trimester prenatal screening program between January 2006 and July 2010.

Results: Maternal serum TSH levels were lower and free T4, and transaminases (ALT, AST) levels were higher in pregnancies complicated with HG compared with controls (p < 0.05 for all). In HG cases, median values of maternal serum PAPP-A were significantly higher with respect to normal pregnancies (1.2 vs 1.0 MoM; p = 0.009). Similarly, median values of free β-hCG were 1.3 MoM in HG pregnancies and 1.0 MoM in controls (p = 0.006). Multivariate analysis revealed that PAPP-A and hCG were independently associated with HG after controlling for TSH, free T4, AST, and ALT.

Conclusion: HG is associated with elevated levels of PAPP-A and free β-hCG, and such changes are independent of serum indicators of thyroid and liver function.

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Chorionic Gonadotropin, beta Subunit, Human / blood*
  • Female
  • Humans
  • Hyperemesis Gravidarum / blood*
  • Hyperemesis Gravidarum / diagnosis
  • Pregnancy
  • Pregnancy Trimester, First / blood*
  • Pregnancy-Associated Plasma Protein-A / metabolism*
  • Thyrotropin / blood
  • Thyroxine / blood

Substances

  • Chorionic Gonadotropin, beta Subunit, Human
  • Thyrotropin
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Pregnancy-Associated Plasma Protein-A
  • Thyroxine