Association Between Serum Markers Used in the Routine Prenatal Screening with Pregnancy Outcomes: A Cohort Study

Abstract

Early detection of adverse pregnancy outcomes is an important topic in prenatal care. This study aimed to evaluate the association between maternal serum markers and pregnancy outcomes. This hospital-based cohort study was performed according to the national Down syndrome screening protocol on 2923 eligible pregnant women. Pregnancies were classified into three groups of based on each biomarker. The participants were followed up until delivery, and the pregnancy outcomes were identified by hospital discharge records. High levels of free BHCG were significantly associated with an increased risk of preterm birth (B\u2009=\u2009− 0.31, SE\u2009=\u20090.158, OR\u2009=\u20090.730; P\u2009=\u20090.046). Based on multivariate analysis the high levels of MSAFP had a direct relationship with premature birth (B\u2009=\u2009− 0.84, SE\u2009=\u20090.361, OR\u2009=\u20090.431, P\u2009=\u20090.020), gestational hypertension (B\u2009=\u2009− 0.59, SE\u2009=\u20090.354, OR\u2009=\u20090.549. P\u2009=\u20090.091), IUGR (B\u2009=\u2009− 1.46, SE\u2009=\u20090.433, OR\u2009=\u20090.231, P\u2009=\u20090.001), and fetal death (B\u2009=\u2009− 1.50, SE\u2009=\u20090.533, OR\u2009=\u20090.223, P\u2009=\u20090.005). Furthermore, an increase in the levels of Inhibin-A could more likely lead to gestational hypertension (B\u2009=\u2009− 0.63, SE\u2009=\u20090.235, OR\u2009=\u20090.533). According to the result, maternal biomarkers, especially MSAFP, can be beneficial in identifying high-risk cases, in addition to examining the possibility of Down syndrome, facilitating achievement of the desired pregnancy outcomes.