Value of α-fetoprotein, β-HCG, inhibin A, and UE3 at second trimester for early screening of preeclampsia

Abstract

Objective: To study the value of α -fetoprotein (α -FP), β-human chorionic gonadotropin (β-HCG), inhibin A, and uncojugated estriol (UE3) at the second trimester for early screening of preeclampsia. Methods: This cohort study was performed on 1 713 consecutive pregnant women with gestational age from 15 to 18 weeks. We measured the serum levels of α -FP, β -HCG, inhibin A, and UE3 and they were followed-up for 48 h after delivery. Results: A total of 1 713 women were recruited and through the study 151 women (8.8%) were diagnosed with preeclampsia (n=123, 21.5% in the pregnant women with high risk, n=28, 2.5% in the pregnant women with low risk; P<0.000 1). The area under receiver operating characteristic curve was estimated to be 2.39 MOM for α-FP, 2.84 MOM for β-HCG, 1.92 MOM for inhibin A, and 0.77 MOM for UE3. The best cutoff value was specifically considered for each marker that was determined a positive predictive value ranged 19.60% for α-FP, 17.62% for β -HCG, 18.33% for inhibin A and 14.88% for UE3, a negative predictive value ranged 95.63% for ct-FP, 93.89% for β-HCG, 94.28% for inhibin A and 93.57% for UE3, and an area under receiver operating characteristic curve ranged 0.70 for α-FP, 0.63 for β -HCG, 0.65 for inhibin A and 0.61 for UE3. Conclusions: This study reveals that the new cutoff values are more valuable in screening preeclampsia. Although these markers have a low positive predictive value, they present a high negative predictive value. Also, the combination of α-FP, β-HCG and inhibin A and the combination of α-FP and inhibin A have the highest value in screening preeclampsia.