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.