Evaluation of first trimester serum double marker test in prediction of fetal growth restriction

Objectives: To evaluate the clinical utility of the first trimester serum double marker test in their ability to predict subsequent delivery of a fetal growth restriction (FGR) infant. Methods: The association between first trimester double marker test and the incidence of FGR were assessed by comparing the relative incidence at their MoM cut-offs and their sensitivity, specificity were calculated. Results: The FGR group constituted 35 FGR pregnancy and non FGR case constituted 50 normal pregnancy. The mean level of β-hCG was reduced in FGR group (i.e.0.94 ±0.70 MoM Vs 1.49 ±0. 75 MoM; P value < 0.05) but its sensitivity for prediction of future FGR was found to be 48 % only. The mean level for serum PAPP-A was significantly reduced in FGR group of patients (i.e.0.76 ± 0.45 Vs 1.16 ± 0.53; p value = 0.0005) with the sensitivity for prediction of FGR of 54.3 %. With serum PAPP-A level, a weak positive relationship was found with birth weight the association of which was statistically significant. Conclusions: Low levels of maternal serum PAPP-A and serum free β-hCG are associated, in the absence of an abnormal karyotype, with an increased risk for subsequent delivery of an FGR infant.