Evaluation of the role of biochemical and biophysical parameters of combined prenatal screening of the first trimester in the of insufficient fetal growth development

Aim. To evaluate the role of biochemical and biophysical parameters in the combined first-trimester prenatal screening for the development of clinical forms of fetal growth insufficiency.

Materials and methods. Group I (main) included 73 patients, whose pregnancies were complicated by the fetal growth insufficiency. The main group was divided into two subgroups: Ia with 30 patients whose pregnancies were complicated by fetal growth restriction (FGR) and Ib with 43 patients whose pregnancies were complicated by small for gestational age fetuses (SGA). Group II (control) included 118 patients whose pregnancies resulted in the birth of a live, full-term infant with normal height and weight. All patients underwent combined first-trimester prenatal screening with calculation of biochemical (pregnancy-associated plasma protein A (PAPP-A), free β-subunit of human chorionic gonadotropin (β-hCG) and biophysical (mean arterial pressure (MAP), uterine artery pulsatility index (PI) parameters, the values of which were subsequently analyzed.

Results. The level of PAPP-A was statistically significantly lower in the FGR group (0.793 MoM) compared to the control group (1.048 MoM), p = 0.005. The level of PAPP-A in the blood below 0.793 MoM increases the risk of fetal growth restriction by 3.244 times (odds ratio (OR) = 3.244; 95% confidence interval (95% CI) 1.394–7.554, p = 0.005). An increase in the pulsation index was found in Doppler ultrasound of the uterine arteries in patients with FGR compared to the SGA group (OR = 2.254; 95% CI 0.990–5.129, p = 0.017). Statistically significant differences were not found in the studied parameters of the combined first-trimester prenatal screening in relation to the development of SGA.

Conclusion. Differences in the biochemical and biophysical parameters of combined prenatal screening for the clinical forms of the fetal growth insufficiency were identified. Further research is needed to identify new prognostic markers of fetal growth insufficiency, which will help reduce perinatal losses. Additional research is required to expand the sample size of the Russian population to clarify the role of the prenatal screening components.

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