Correlation of serum biomarkers with treatment result in women with first trimester threatened miscarriage

Abstract

Objectives: To assess the correlation of serum biomarkers with treatment result in women with first trimester threatened miscarriage.
 Materials and methods: Cross-sectional observative study in 107 patients which were first trimester threatened miscarriage at Department of Obstetrics and Gynecology, Hue Central Hospital and Hospital of Hue Medicine and Pharmacy University from March 2021 to June 2022. Inclusion criteria included women with threatened miscarriage and gestational age ≤ 13 weeks and 6 days. Participants were measured the levels of biomarkers (PAPP - A, CA 125, β-hCG, progesterone) and divided into two groups: group 1 included 90 women with successful treatment (continued pregnancy), and group 2 included 17 women with failed treatment (miscarriage, stillbirth).
 Results: The level of maternal serum PAPP - A, β-hCG and progesterone for the successful treatment group were higher than the failed treatment group (p < 0.05). The median PAPP - A in group 1 and group 2 were 0.59 (0.12 - 2.04) IU/L and 0.02 (0.01-0.04) IU/L, respectively. The cut-off limit of 0.088 IU/L of PAPP - A level achieved sensitivity of 77.8% and specificity of 94.1%. The cut-off limit of 8004.5 mIU/ml of β-hCG level for ≤ 6 weeks gestational age group achieved sensitivity of 92% and specificity of 84.6%. The cut-off β-hCG value of 29162.5 mIU/ml for over 6 weeks to 13 weeks and 6 days group gave a sensitivity of 98.5% and specificity of 100%. The threshold progesterone value of 14.13 ng/dl gave a sensitivity of 93.3%, specificity of 94.1%. The median CA 125 in the group 2 was 74.01 (32.75 - 103.00) U/ml, that was higher than group 2 which was 40.90 (27.28 - 76.76) U/ml, p > 0.05. The cut-off CA 125 value of 68.55 U/ml for miscarriages gave a sensitivity of 58.8% and specificity of 71.1%.
 Conclusions: Levels of maternal serum PAPP – A, CA 125, β-hCG and progesterone were early predictors of pregnancy outcome in women with first trimester threatened miscarriage.