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. 2019 Apr 11;19(1):124.
doi: 10.1186/s12884-019-2266-y.

A cohort study of the association between maternal serum Inhibin-A and adverse pregnancy outcomes: a population-based study

Wannaporn Singnoi  1 , Chanane Wanapirak  1 , Ratanaporn Sekararithi  1 , Theera Tongsong  2
Affiliations

A cohort study of the association between maternal serum Inhibin-A and adverse pregnancy outcomes: a population-based study

Wannaporn Singnoi et al. BMC Pregnancy Childbirth. .

Abstract

Background: To compare the rates of adverse pregnancy outcomes between women with normal and abnormal inhibin-A levels.

Methods: Based on a prospective database of Down syndrome screening program, the consecutive records were comprehensively reviewed. Pregnancies were classified into three groups: normal, high (> 2 MoM) and low (< 0.5 MoM) inhibin-A levels. The pregnancies with medical diseases, chromosome abnormalities and fetal anomalies were excluded. The primary outcomes were the rates of preterm birth, preeclampsia, and fetal growth restriction (FGR).

Results: Of 6679 recruited pregnancies, 5080 met the inclusion criteria, including 4600, 205 and 275 pregnancies in the group of normal, high, and low inhibin-A levels respectively. The rates of preterm birth, preeclampsia and FGR were significantly higher in the group of high levels; (RR, 1.51, 95%CI: 1.01-2.26; 3.47, 95% CI: 2.13-5.65; 3.04, 95% CI: 1.99-4.65 respectively), whereas the rates of other adverse outcomes were comparable. However, the rate of spontaneous preterm birth among women with high inhibin-A was not significantly increased. Based on multivariate analysis, the preterm birth rate was not significantly associated with inhibin-A levels, but it was rather a consequence of preeclampsia and FGR. Low levels of serum inhibin-A were not significantly associated with any adverse outcomes.

Conclusions: High levels of maternal serum inhibin-A in the second trimester are significantly associated with abnormal placentation, which increases the risk of preeclampsia and FGR with a consequence of indicated preterm birth but not a risk of spontaneous preterm birth. In contrast, low inhibin-A levels were not associated with any common adverse pregnancy outcomes.

Keywords: Fetal growth restriction; Inhibin-a; Preeclampsia; Preterm birth; Serum marker screening.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Boards; The Research Ethics Committee 4; Faculty of Medicine, Chiang Mai University. Study code: OBG-2560-04899/ Research ID: 4899.

All participants were recruited with written informed consent.

Consent for publication

The Informed Consent Forms which all participants signed included consent for publication of their data. Data were de-identified after collection and participants were allocated codes for analysis and pseudonyms for publication.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of the participant recruitment
Fig. 2
Fig. 2
Kaplan-Meier curves of gestational age derived from Cox regression analysis show comparisons between the women with normal and high inhibin-A group (a), and the women with and without preeclampsia (b)
See this image and copyright information in PMC

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