Elevated second trimester human chorionic gonadotropin level associated with adverse pregnancy outcome.

OBJECTIVE

Our purpose was to determine whether unexplained elevations in maternal serum human chorionic gonadotropin in the second trimester may be associated with adverse pregnancy outcome.

METHOD: Between April 1992 and April 1995, 610 pregnant women undergoing second trimester triple marker screening for Down syndrome who delivered at our institution were evaluated. Eighty-one women with a hCG level greater than 2.0 multiples of the median (MoM) were included in the study group while 481 women with hCG levels < 2.0 MoM served as controls. Pregnancies with fetal chromosomal and structural anomalies and maternal serum alpha-fetoprotein levels greater than 2.0 MoM were excluded from the study. Pregnancy outcomes were obtained from hospital delivery records. Statistical analysis were performed by Student's t-test; odds ratios and 95% confidence intervals were also calculated.

RESULTS

Women with elevated human chorionic gonadotropin levels showed an increased risk for preeclampsia (odds ratio (OR): 5.93, 95% confidence interval (CI): 1.97-15.88), intrauterine growth retardation (OR: 5.34, 95% CI: 2.14-13.34), preterm delivery (OR: 5.66, 95% CI: 3.22-9.98), and preterm premature rupture of membranes (OR: 3.15, 95% CI: 1.23-8.07).

CONCLUSION

Unexplained elevation of human chorionic gonadotropin in the second trimester appears to be associated with adverse pregnancy outcome.