Longer time-to-pregnancy in spontaneously conceived pregnancies is associated with lower PAPP-A and free β-hCG in first trimester screening for Down syndrome

TY - JOUR

T1 - Longer time-to-pregnancy in spontaneously conceived pregnancies is associated with lower PAPP-A and free β-hCG in first trimester screening for Down syndrome

AU - Kirkegaard, I

AU - Uldbjerg, N

AU - Tabor, A

AU - Henriksen, T B

N1 - © 2013 John Wiley & Sons, Ltd.

PY - 2014/3

Y1 - 2014/3

N2 - Objective: The aim of this study was to investigate whether subfertility, measured as longer time-to-pregnancy (TTP) in spontaneously conceived pregnancies, affects the first trimester levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotrophin (β-hCG) and hence the risk estimates in Down syndrome screening. Methods: The study included a cohort of 10469 singleton pregnant women who underwent first trimester combined screening and responded to a questionnaire regarding TTP. PAPP-A and free β-hCG levels were measured between gestational week 8+0 and 13+6 and were related to TTP. Results: The median PAPP-A and free β-hCG MoMs were significantly lower in women with a TTP ≥24months compared with the reference group with a TTP <6months (PAPP-A: 0.96 vs 1.06MoM, p=0.003; free β-hCG: 1.04 vs 1.12MoM, p=0.03). This led to an increased odds for trisomy 21 risk ≥1:300 for TTP ≥24months compared with TTP <6months, but when adjusting for potential confounders, the odds ratio (OR) lost significance (OR 1.4, 95% confidence interval; 0.8-2.4). Conclusion: Time-to-pregnancy ≥24months in spontaneously conceived pregnancies is associated with decreased levels of PAPP-A and free β-hCG.

AB - Objective: The aim of this study was to investigate whether subfertility, measured as longer time-to-pregnancy (TTP) in spontaneously conceived pregnancies, affects the first trimester levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotrophin (β-hCG) and hence the risk estimates in Down syndrome screening. Methods: The study included a cohort of 10469 singleton pregnant women who underwent first trimester combined screening and responded to a questionnaire regarding TTP. PAPP-A and free β-hCG levels were measured between gestational week 8+0 and 13+6 and were related to TTP. Results: The median PAPP-A and free β-hCG MoMs were significantly lower in women with a TTP ≥24months compared with the reference group with a TTP <6months (PAPP-A: 0.96 vs 1.06MoM, p=0.003; free β-hCG: 1.04 vs 1.12MoM, p=0.03). This led to an increased odds for trisomy 21 risk ≥1:300 for TTP ≥24months compared with TTP <6months, but when adjusting for potential confounders, the odds ratio (OR) lost significance (OR 1.4, 95% confidence interval; 0.8-2.4). Conclusion: Time-to-pregnancy ≥24months in spontaneously conceived pregnancies is associated with decreased levels of PAPP-A and free β-hCG.

KW - Adult

KW - Biological Markers

KW - Chorionic Gonadotropin, beta Subunit, Human

KW - Cohort Studies

KW - Down Syndrome

KW - Female

KW - Humans

KW - Pregnancy

KW - Pregnancy Trimester, First

KW - Pregnancy-Associated Plasma Protein-A

KW - Time-to-Pregnancy

U2 - 10.1002/pd.4295

DO - 10.1002/pd.4295

M3 - Journal article

C2 - 24338604

SN - 0197-3851

VL - 34

SP - 235

EP - 240

JO - Prenatal Diagnosis

JF - Prenatal Diagnosis

IS - 3

ER -