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Elevated second-trimester human chorionic gonadotropin and subsequent pregnancy-induced hypertension
T K Sorensen1, M A Williams, R W Zingheim
1Division of Perinatal Medicine, Swedish Medical Center/Seattle, WA 98104.
American Journal of Obstetrics and Gynecology
|October 1, 1993
Summary
Elevated second-trimester human chorionic gonadotropin (hCG) levels indicate a higher risk for developing pregnancy-induced hypertension. This finding suggests hCG may serve as an early marker for this condition.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Endocrinology
Background:
- Pregnancy-induced hypertension (PIH) is linked to vascular endothelial dysfunction, potentially originating in the placenta.
- Early markers like cellular fibronectin are observed in patients who later develop PIH.
Purpose of the Study:
- To investigate the hypothesis that elevated second-trimester human chorionic gonadotropin (hCG) levels are associated with an increased risk of developing PIH.
- To explore hCG as a potential predictive marker for PIH.
Main Methods:
- A cohort study analyzed data from 180 women with second-trimester hCG levels ≥ 2.0 multiples of the median (MoM).
- A referent group of 369 women with hCG levels < 2.0 MoM was used for comparison.
- Standard definitions for PIH and proteinuria were applied.
Main Results:
- Women with elevated second-trimester hCG levels had a 1.7-fold increased risk of PIH (95% CI 1.2–2.4).
- The risk for proteinuric PIH was significantly higher, with a risk ratio of 5.1 (95% CI 1.6–16.2).
- Associations remained significant after adjusting for potential confounding factors.
Conclusions:
- Elevated second-trimester hCG levels are associated with a higher risk of pregnancy-induced hypertension, including proteinuric PIH.
- Second-trimester hCG levels warrant further investigation as a predictive marker for PIH.