Department of Prenatal Diagnosis and Screening Center, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Shangcheng District Hangzhou, No. 369, Kunpeng Road, Zhejiang, 310008, China.
School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
BMC Womens Health. 2024 Jun 4;24(1):323. doi: 10.1186/s12905-024-03105-z.
A retrospective cohort study was conducted to collect the data of pregnant women who received hospital delivery in Hangzhou Women's Hospital from January 2018 to December 2020, and who participated in the second trimester (15-20 weeks) of free beta human chorionic gonadotropin (free β-hCG). And the study was conducted to explore the relationship between maternal serum free β-hCG and adverse pregnancy outcomes (APO).
We retrospectively analyzed the clinical data of 1,978 women in the elevated maternal serum free β-hCG group (free β-hCG ≥ 2.50 multiples of the median, MoM) and 20,767 women in the normal group (0.25 MoM ≤ free β-hCG < 2.50 MoM) from a total of 22,745 singleton pregnancies, and modified Poisson regression analysis was used to calculate risk ratios (RRs) and 95% confidence intervals (CI) of the two groups.
The gravidity and parity in the elevated free β-hCG group were lower, and the differences between the groups were statistically significant (all, P < 0.05). The risks of polyhydramnios, preeclampsia, and hyperlipidemia, were increased in women with elevated free β-hCG levels (RRs: 1.996, 95% CI: 1.322-3.014; 1.469, 95% CI: 1.130-1.911 and 1.257, 95% CI: 1.029-1.535, respectively, all P < 0.05), intrauterine growth restriction (IUGR) and female infants were also likely to happen (RRs = 1.641, 95% CI: 1.103-2.443 and 1.101, 95% CI: 1.011-1.198, both P < 0.05). Additionally, there was an association between elevated AFP and free β-hCG levels in second-trimester (RR = 1.211, 95% CI: 1.121-1.307, P < 0.001).
APOs, such as polyhydramnios, preeclampsia, and hyperlipidemia, were increased risks of elevated free β-hCG levels, IUGR and female infants were also likely to happen. Furthermore, there was an association between elevated AFP levels and elevated free β-hCG levels in second-trimester. We recommend prenatal monitoring according to the elevated maternal serum free β-hCG level and the occurrence of APO.
本回顾性队列研究收集了 2018 年 1 月至 2020 年 12 月在杭州市妇产科医院分娩的孕妇数据，这些孕妇均在孕中期（15-20 周）接受了免费人绒毛膜促性腺激素-β（free β-hCG）检测，旨在探讨母体血清游离β-hCG 与不良妊娠结局（APO）的关系。
本研究回顾性分析了 1978 例母体血清游离β-hCG 升高组（free β-hCG≥2.50 中位数倍数，MoM）和 20767 例游离β-hCG 正常组（0.25 MoM≤free β-hCG＜2.50 MoM）的 22745 例单胎妊娠的临床资料，采用修正泊松回归分析计算两组的风险比（RR）和 95%置信区间（CI）。
游离β-hCG 升高组的孕次和产次较低，组间差异有统计学意义（均 P＜0.05）。游离β-hCG 水平升高的孕妇发生羊水过多、子痫前期和高脂血症的风险增加（RRs：1.996，95%CI：1.322-3.014；1.469，95%CI：1.130-1.911 和 1.257，95%CI：1.029-1.535，均 P＜0.05），胎儿生长受限（IUGR）和女婴也更可能发生（RRs=1.641，95%CI：1.103-2.443 和 1.101，95%CI：1.011-1.198，均 P＜0.05）。此外，游离β-hCG 水平与妊娠中期 AFP 水平升高之间存在相关性（RR=1.211，95%CI：1.121-1.307，P＜0.001）。
游离β-hCG 水平升高与羊水过多、子痫前期和高脂血症等不良妊娠结局的发生风险增加有关，胎儿生长受限和女婴的发生风险也增加。此外，游离β-hCG 水平与妊娠中期 AFP 水平升高之间存在相关性。建议根据母体血清游离β-hCG 水平升高和不良妊娠结局的发生情况进行产前监测。
