First and second trimester hCG levels have no value in predicting small for gestational age infants

Abstract

Introduction Fetal growth restriction is an important contributor to perinatal mortality and morbidity, as well as being a modulator of abnormal neurodevelopment [1]. Early identification and appropriate management of these fetuses at risk was shown to decrease the associated mortality by four-fold [2]. Human chorionic gonadotropin (hCG) was first used in 1987 to predict pregnancies with Down syndrome [3]. Both first trimester and second trimester screening tests for Down syndrome use hCG. HCG secretion begins very early in 216 Cumhuriyet Tıp Dergisi Cumhuriyet Tıp Derg 2013; 35: 215-220 Cumhuriyet Medical Journal Cumhuriyet Med J 2013; 35: 215-220 pregnancy and reaches peak values at about 10 weeks of gestation, than the values decrease gradually and stay stable after the twentieth week of pregnancy. In pregnancies with small for gestational age (SGA) fetuses the placental content is also small, so previously an association was suggested between low first trimester hCG levels and delivering a SGA infant [3-7], which was rejected by other studies [8-10]. Goetzinger et al suggested an association between high first trimester hCG levels and the delivery of a SGA infant [11]. The aim of this study was to compare the efficacy of high hCG levels in the first and second trimester in predicting SGA infants. To the best of our knowledge this is the first study that compares hCG levels at first and second trimesters