Association between first trimester serum markers and risk of fetal congenital heart defect

Background: This study aimed to assess the association between maternal first-trimester biomarkers in fetuses with non-chromosomal Congenital Heart Defect (CHD) and similar pregnancies with normal fetuses.Method:The first-trimester serum level of Pregnancy-Associated Plasma Protein-A (PAPP-A) and free beta-human Chorionic Gonadotropin (hCG( were evaluated in 56 cases of isolated fetal heart defects and 224 normal controls. The CHDs were divided into Critical CHD (CCHD) and Non-critical CHD (N CHD) groups. The variables were converted into Multiples of the Median (MoM) .Logistic regression techniques were used to examine the biomarker relationships in the total, C CHD, and N CHD groups as opposed to the controls without CHDs.Results:The median values for PAPP-A were significantly lower in total CHDs than controls (0.87 MoM vs 0.92MoM; p=0.008 ) . This significancy was reported especially in the C CHDs (P<0.001).There were no significant differences based on free β-hCG within the groups. Conclusion: The lower PAPP-A values can contribute to the prediction of fetal CHD development, therefore in pregnant women with lower level of PAPP-A , earlier fetal cardiac screening ultrasonography was suggested to detect fetal cardiac abnormalities

Keywords:

Congenital heart defect , biomarker , PAPP-A