Obstetric outcomes in women with elevated maternal serum human chorionic gonadotropin.

OBJECTIVE

This study was undertaken to assess outcomes in unselected women with maternal serum human chorionic gonadotropin (MShCG) 2.0 MoM or greater.

STUDY

DESIGN

This is an observational cohort study of 309 women with MShCG 2 MoM or greater and 309 women of the same age and ethnicity with MShCG less than 2.0 MoM who were evaluated for preterm delivery (PTD), preeclampsia, stillbirth, birth weight 10% or less, and birth weight 90% or greater (larger for gestational age [LGA]). Confounding variables evaluated were nulliparity, prior PTD, chronic hypertension, diabetes, and maternal serum alpha-fetoprotein and estriol.

RESULTS

There was no overall increase in adverse outcomes despite associations found with PTD for preeclampsia with MShCG 3.0 MoM or greater (odds ratio [OR] 5.9, CI 1.5-23.2) and PTD for fetal indications with MShCG 4.0 MoM or greater (OR 45.5, CI 4.1-509). There was an increase of LGA infants with MShCG 3.0-3.9 MoM (OR 2.5, CI 1.0-5.8).

CONCLUSION

Adverse pregnancy outcome is associated with MShCG 3.0 MoM or greater, thus increased surveillance is not warranted with lower values.