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Maternal urine beta-core hCG fragment level and small for gestational age neonates

Bahado-Singh, R.; Oz, U.; Flores, D.; Hsu, C.; Mari, G.; Cole, L.

Obstetrics and Gynecology 95(5): 662-666

2000

ISSN/ISBN: 0029-7844
PMID: 10775725
Document Number: 525514
Objective: To determine whether second-trimester urine beta-core fragments of hCG predict small for gestational age (SGA) neonates. Methods: Spot urine beta-core levels were measured in 733 nonhypertensive women with singleton pregnancies who presented for amniocentesis and had karyotypically normal fetuses. The beta-core level was standardized to urine creatinine and expressed as multiples of the median. The area under a receiver operating characteristics curve was used to determine the screening efficiency of the urine analyte for prediction of small for gestational age (SGA) births. In a subgroup of cases, serum markers (alpha-fetoprotein (AFP), hCG, and unconjugated estriol) were compared using stepwise regression analysis to urine beta-core fragment for SGA prediction. Results: There were 23 (3.0%) SGA neonates. The mean +- standard deviation (SD) gestation at urine collection was 16.4 +- 1.3 weeks and collection to delivery interval was 23.0 +- 2.2 weeks. Mean beta-core (+- SD) fragment levels were significantly higher in those who later had SGA infants compared with appropriately grown infants (2982.8 ng/mg creatinine versus 1447.4 ng/mg creatinine, P < .001). Stepwise logistic regression found that urine beta-core fragment and serum AFP were the only significant predictors of SGA, with statistically significant chi2 values (P < .001 and P = .038, respectively). The urine analyte was significantly superior. Second-trimester urine beta-core fragment had a 78.3% sensitivity and 70% specificity for SGA prediction. Exclusion of preeclamptic cases resulted in a sensitivity of 84.2% and a specificity of 71.2%. Conclusion: Second-trimester elevated maternal urine beta-core fragment of hCG predicted SGA infants, and was superior to other serum analytes in that prediction.

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