First-trimester serum biomarkers in twin pregnancies and adverse obstetric outcomes-a single center cohort study.
Arch Gynecol Obstet
; 310(1): 315-325, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38734998
ABSTRACT
PURPOSE:
This study aimed to determine the association of first-trimester maternal serum biomarkers with preterm birth (PTB), fetal growth restriction (FGR) and hypertensive disorders of pregnancy (HDP) in twin pregnancies.METHODS:
This is a retrospective cohort study of twin pregnancies followed at Maternidade Dr. Alfredo da Costa, Lisbon, Portugal, between January 2010 and December 2022. We included women who completed first-trimester screening in our unit and had ongoing pregnancies with two live fetuses, and delivered after 24 weeks. Maternal characteristics, pregnancy-associated plasma protein-A (PAPP-A) and ß-human chorionic gonadotropin (ß-hCG) levels were analyzed for differentoutcomes:
small for gestational age (SGA), gestational hypertension (GH), early and late-onset pre-eclampsia (PE), as well as the composite outcome of PTB associated with FGR and/or HDP. Univariable, multivariable logistic regression analyses and receiver-operating characteristic curve were used.RESULTS:
466 twin pregnancies met the inclusion criteria. Overall, 185 (39.7%) pregnancies were affected by SGA < 5th percentile and/or HDP. PAPP-A demonstrated a linear association with gestational age at birth and mean birth weight. PAPP-A proved to be an independent risk factor for SGA and PTB (< 34 and < 36 weeks) related to FGR and/or HDP. None of the women with PAPP-A MoM > 90th percentile developed early-onset PE or PTB < 34 weeks.CONCLUSION:
A high serum PAPP-A (> 90th percentile) ruled out early-onset PE and PTB < 34 weeks. Unless other major risk factors for hypertensive disorders are present, these women should not be considered candidates for aspirin prophylaxis. Nevertheless, close monitoring of all TwP for adverse obstetric outcomes is still recommended.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Proteína Plasmática A Associada à Gravidez
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Primeiro Trimestre da Gravidez
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Biomarcadores
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Gonadotropina Coriônica Humana Subunidade beta
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Hipertensão Induzida pela Gravidez
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Nascimento Prematuro
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Retardo do Crescimento Fetal
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Gravidez de Gêmeos
Limite:
Adult
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Female
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Humans
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Newborn
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Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
Arch Gynecol Obstet
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Portugal