Abstract
Objective. Determine the level of early prenatal biochemical parameters in pregnant women with antenatally diagnosed fetal congenital heart defect (CHD).
Material and methods. In a case-control study that included 2200 singleton pregnancies: 151 patients with antenatally diagnosed fetal CHD (main group), 2049 patients without signs of fetal malformations (control group), an analysis of maternal characteristics, the level of biochemical markers of early prenatal screening using values multiples of the median (MoM) of pregnancy-associated protein A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (β-hCG), data on pregnancy outcomes were performed.
Results. Clinical and epidemiological characteristics of pregnant women did not have statistical differences between the groups. The median values of birthweight in the main group were significantly lower than in the control group (3240 grams vs 3420 grams) (p = 0.04). The number of cases of small-for-gestational-age, i.e. birthweight below the 10th percentile, was significantly higher in the main group than in the control group: 14 (9.3%) newborns with CHD vs 12 (5.9%) babies in the control group (p < 0.001).
The main group showed a statistically significant decrease in the level of beta-hCG compared to the control group: 0.89 MoM vs 1.11 MoM (p < 0.0001), the level of PAPP-A did not differ statistically significantly between the groups (p = 0.19).
Conclusion. The high frequency of small-for-gestational-age newborns with CHD compared to the control cohort and a significant decrease in the level of angiogenic factor β-hCG in the blood serum of pregnant women with fetal cardiac pathology, which is not currently used in population algorithms for calculating the risk of placental dysfunction, may indicate the need to expand the panel of biomarkers in predicting fetal compromise in this group of patients.
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About the authors
- Tamara A. Yarygina, Cand. Med. Sci., Researcher, Associated Professor, Head of Department; ORCID
- Rena M. Gasanova, Dr. Med. Sci., Research Associate, Cardiologist, Head of Department; ORCID
- Elena V. Sypchenko, Cand. Med. Sci., Ultrasonic Diagnostician; ORCID
- Elena I. Leonova, Ultrasonic Diagnostician; ORCID
- Olga V. Marzoeva, Cand. Med. Sci., Researcher, Ultrasonic Diagnostician; ORCID
