The evaluation of the first-trimester biochemical parameters of combined aneuploidy screening test in pregnant women with polycystic ovary syndrome (PCOS)

Background: The maternal serum levels of pregnancy-associated plasma protein- A (PAPP-A) and free β – human chorionic gonadotropin (β-h CG) are being used as a biochemical markers to screen pregnancies with aneuploid fetuses. The serum concentrations of both molecules are related with decidualization and placentation process. Endothelial damage and impaired decidual trophoblast invasion were detected in pregnancies with polycystic ovary syndrome (PCOS). Recent studies suggested significant alterations in serum concentrations of PAPP-A and β-h CG in pregnant women with PCOS. Objective: The aim of this study was to evaluate the effect of polycystic ovarian syndrome on the biochemical components of first trimester combined aneuploidy screening test.Methods: A prospective case-control study was conducted on 489 women with singleton pregnancy in the first trimester (11+0-13+6weeks ) at an academic tertiary care center between March 2014 and April 2017. One hundred and twenty four women who met Rotterdam criteria for PCOS before pregnancy constituted the study group and 365 women were with proven absence of PCOS formed the control group. Maternal PAPP-A, free β-h CG, and fetal nuchal translucency (NT) were measured and compared between the both groups.Results: The data regarding to baseline characteristics including gestational and maternal age, gravity, parity, maternal weight, and BMI were similar between two groups. In pregnant women with PCOS, the multiple median (MOM) levels of serum PAPP-A were significantly decreased when compared with those of the control group (ρ=0.02). No statistically significant differences in terms of the multiple median (MOM) levels of serum free β-h CG and NT measurements were detected between the PCOS group and the control group ρ=0.213, ρ=0.157, respectively). Conclusions: The data suggested that impaired decidual trophoblast invasion in pregnant women with PCOS could affect the serum PAPP-A concentrations. Further studies are needed in order to confirm our results and add PCOS as a risk factor that changes the results of biochemical components of first trimester combined aneuploidy screening test.

Keywords:

Polycystic ovarian syndrome , PAPP-A , free β-h CG , First-trimester screening test , Aneuploidy