The impact of maternal predisposing factors on level of maternal serum pregnancy-associated plasma protein A and free subunit human chorionic gonadotropin and nuchal translucency

Authors
Maryam Mirsafaie 1
Majid Kheirollahi 2
Lida Moghaddam-Banaem 2
1 Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
2 Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: This study aimed to investigate the relationship between maternal predisposing factors with the level of maternal serum pregnancy-associated plasma protein A and free subunit human chorionic gonadotropin and nuchal translucency.
Materials and Methods: We performed a cross-sectional-analytical study on 762 pregnant women who referred to the Gene Azma Medical Genetics Laboratory in Isfahan for amniocentesis. All pregnant women at high risk of screening in the first trimester of pregnancy for trisomy 21 and other aneuploidy were referred to a gynecologist for amniotic fluid sampling (amniocentesis). Multiple of the means (MoM) of PAPPA ≤0.5, 0.5 ≥ MoM free β-hCG >2.5, and NT ≥3.5 mm were considered abnormal. We used Chi-square method and Mann–Whitney U-test to compare data qualitative and quantitative, respectively.
Results: In individuals with less pregnancies and deliveries, the value of abnormal NT was higher (P < 0.01, P < 0.001, respectively). On the other hand, the highest abnormal rate of NT was observed in pregnant women under 35 years (21, 84%, P < 0.012). In addition, abnormal levels of free β-hCG are more common in women < 35 years of age (186, 66.9%, P < 0.02) and female fetuses (171, 58.8%) (P < 0.006).
Conclusion: According to the results of this study, it can be said that considering the underlying factors of pregnant mothers in performing tests related to screening in the first trimester of pregnancy can lead to a reduction in false positive rates.

Keywords

1.
Cowans NJ, Stamatopoulou A, Maiz N, Spencer K, Nicolaides KH. The impact of fetal gender on first trimester nuchal translucency and maternal serum free β-hCG and PAPP-A MoM in normal and trisomy 21 pregnancies. Prenat Diagn 2009;29:578-81.  Back to cited text no. 1
    
2.
Zhong Y, Zhu F, Ding Y. Serum screening in first trimester to predict pre-eclampsia, small for gestational age and preterm delivery: Systematic review and meta-analysis. BMC Pregnancy Childbirth 2015;15:1-10.  Back to cited text no. 2
    
3.
Patil M, Panchanadikar T, Wagh G. Variation of papp-a level in the first trimester of pregnancy and its clinical outcome. J Obstet Gynaecol India 2014;64:116-9.  Back to cited text no. 3
    
4.
Brambati B, Tului L, Bonacchi I, Shrimanker K, Suzuki Y, Grudzinskas J. Serum PAPP-A and free β-hCG are first-trimester screening markers for Down syndrome. Prenat Diagn 1994;14:1043-7.  Back to cited text no. 4
    
5.
Tarquini F, Di Renzo GC, Picchiassi E, Centra M, Pennacchi L, Galeone F, et al. 205: Maternal smoking and the amount of cell free fetal DNA in maternal plasma during the first trimester of pregnancy. Am J Obstet Gynecol 2014;210:S111-2.  Back to cited text no. 5
    
6.
Spencer K, Ong C, Skentou H, Liao AW, Nicolaides KH. Screening for trisomy 13 by fetal nuchal translucency and maternal serum free β-hCG and PAPP-A at 10–14 weeks of gestation. Prenat Diagn 2000;20:411-6.  Back to cited text no. 6
    
7.
Illescas T, Fernández C, Ortega D, de la Puente M, Coronado P, Montalvo J. Influence of gravidity and foetal gender on the value of screening variables in the first trimester of pregnancy. Eur J Obstet Gynecol Reprod Biol 2013;167:14-7.  Back to cited text no. 7
    
8.
Yaron Y, Lehavi O, Orr-Urtreger A, Gull I, Lessing JB, Amit A, et al. Maternal serum HCG is higher in the presence of a female fetus as early as week 3 post-fertilization. Hum Reprod 2002;17:485-9.  Back to cited text no. 8
    
9.
Arfi A, Cohen J, Canlorbe G, Bendifallah S, Thomassin-Naggara I, Darai E, et al. First-trimester determination of fetal gender by ultrasound: Measurement of the ano-genital distance. Eur J Obstet Gynecol Reprod Biol 2016;203:177-81.  Back to cited text no. 9
    
10.
Efrat Z, Perri T, Ramati E, Tugendreich D, Meizner I. Fetal gender assignment by first-trimester ultrasound. Ultrasound in Obstetrics and Gynecology: The Official J Int Soc Ultrasound in Obstetrics and Gynecol 2006;27:619-21.  Back to cited text no. 10
    
11.
Colmant C, Morin-Surroca M, Fuchs F, Fernandez H, Senat MV. Non-invasive prenatal testing for fetal sex determination: Is ultrasound still relevant? Eur J Obstet Gynecol Reprod Biol 2013;171:197-204.  Back to cited text no. 11
    
12.
Tonekaboni FR, Narenjisani R, Staji H, Ahmadi-hamedani M. Comparison of cell-free fetal dna plasma content used to sex determination between three trimesters of pregnancy in torkaman pregnant mare. J Equine Veterinary Sci 2020;95:103273.  Back to cited text no. 12
    
13.
Huang T, Meschino WS, Okun N, Dennis A, Hoffman B, Lepage N, et al. The impact of maternal weight discrepancies on prenatal screening results for Down syndrome. Prenat Diagn 2013;33:471-6.  Back to cited text no. 13
    
14.
Khandekar S, Dive A, Munde P. Chromosomal abnormalities-a review. Central India J Dent Sci 2013;4:35-40.  Back to cited text no. 14
Advanced Biomedical Research
Volume 2023, March
March 2023
Pages 1-5