Abnormal Biochemical Analytes Used for Aneuploidy Screening and Adverse Pregnancy Outcomes in Twin Gestations

Objective The objective of this study was to determine if first- and second-trimester biochemical markers for aneuploidy have an association with adverse pregnancy outcomes in twin gestations. Study Design A retrospective cohort study of patients who presented with dichorionic diamniotic twin gestations was performed. Patients with first-trimester low pregnancy-associated plasma protein A (PAPP-A) or low free β human chorionic gonadotropin (β-hCG), or second-trimester elevated α-fetoprotein (AFP), elevated inhibin A, elevated hCG, or low unconjugated estradiol were identified. The rates of adverse pregnancy outcomes were compared between patients with or without abnormal analytes with p <0.05 used as significance. Results In this study, 340 pregnancies were included. Patients with a low PAPP-A had an increased risk for delivery <37 weeks. Patients with an elevated second-trimester hCG had an increased risk for spontaneous delivery <28 weeks and neonatal intensive care unit (NICU) admission. Patients with an elevated inhibin A had an increased risk of spontaneous delivery at <37 and NICU admission. Patients with an elevated AFP had an increased risk of a NICU admission. Conclusion Certain abnormal aneuploidy markers are associated with an increased risk of adverse pregnancy outcomes in twin gestations.