Obstetric outcomes associated with second trimester unexplained abnormal maternal blood markers: A comparative study between outcomes of normal and abnormal blood values

Objectives1) To compare the adverse obstetrical outcomes in the patient population with normal blood MoMs. 2) To determine the probability of occurrence of an adverse obstetric event in relation with abnormal maternal blood analytes.Study settingRetrospective case–control study from August 2006 to December 2011 at the Apollo Centre for Fetal Medicine, Indraprastha Apollo Hospital, New Delhi.MethodsThe study cohort comprised of 2813 women between 16 and 20 weeks of gestation. Women with aneuploidy fetuses were excluded. The study population was categorized into Group A (with abnormal blood MoMs) and Group B (with normal blood MoMs). This was done for all the four blood markers; Maternal Serum Alpha-Feto Protein (MSAFP), Human Chorionic Gonadotropin (hCG), Unconjugated Estriol (uE3) and Inhibin. The cut off used to categorize the women in Group A were MSAFP ≥ 2 MoMs, Free hCG ≥ 2 MoMs, uE3 ≤ 0.5 MoMs and Inhibin ≥ 2 MoMs. The outcomes studied were live births, preterm birth, fetal growth restriction and hypertensive disorders of pregnancy.ResultsThe live birth rate was significantly higher in Group B for all the four blood markers as compared to Group A. Preterm birth, fetal growth restriction and hypertensive disorders of pregnancy were significantly higher (p < 0.001) in Group A than Group B.ConclusionApart from being used as an aneuploidy screen, the second trimester maternal blood analytes can also predict adverse obstetrical outcomes.