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Association between human chorionic gonadotropin (hCG) levels and adverse pregnancy outcomes : A systematic review and meta-analysis

Skogler, Johannes ; Moberg, Tilda ; Tancredi, Luca ; Styrmisdóttir, Lea ; Hedayati, Ehsan ; Alarcon-Ruiz, Christoper A. ; Khamis, Assem ; Persad, Emma ; Iskandarani, Ghida and Hansson, Stefan R. LU orcid , et al. (2023) In Pregnancy Hypertension 34. p.124-137
Abstract

Human chorionic gonadotropin (hCG), a glycoprotein produced in the placenta, is crucial for a healthy pregnancy. We investigated the relationship between hCG levels and adverse pregnancy outcomes. We conducted a systematic review including studies measuring hCG blood levels in the first or second trimester, reporting on any of the 12 predefined adverse pregnancy outcomes with logistic regression-adjusted association estimates. The primary outcomes were placenta-associated complications, such as miscarriage, preeclampsia, intrauterine growth restriction, and preterm delivery. We searched PubMed, Embase and CINAHL Complete. The hCG levels were analysed as multiple of the median (MoM). Odds ratio (OR) and 95% confidence interval (CI) were... (More)

Human chorionic gonadotropin (hCG), a glycoprotein produced in the placenta, is crucial for a healthy pregnancy. We investigated the relationship between hCG levels and adverse pregnancy outcomes. We conducted a systematic review including studies measuring hCG blood levels in the first or second trimester, reporting on any of the 12 predefined adverse pregnancy outcomes with logistic regression-adjusted association estimates. The primary outcomes were placenta-associated complications, such as miscarriage, preeclampsia, intrauterine growth restriction, and preterm delivery. We searched PubMed, Embase and CINAHL Complete. The hCG levels were analysed as multiple of the median (MoM). Odds ratio (OR) and 95% confidence interval (CI) were used. Risk of bias and the certainty of evidence were assessed using ROBINS-I and GRADE, respectively. Meta-analysis also showed that hCG levels, reported as MoM ≥2/2.31/2.5, might be associated with an increased risk of preeclampsia (OR 2.08, 95% CI 1.26 to 3.44) and preterm delivery (OR 1.29, 95% CI 1.12 to 1.47), but the evidence is very uncertain. High second trimester hCG levels may be associated with preeclampsia and preterm delivery but confidence in evidence is low.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
hCG, Preeclampsia, Pregnancy complications
in
Pregnancy Hypertension
volume
34
pages
14 pages
publisher
Elsevier
external identifiers
  • pmid:37951184
  • scopus:85176590540
ISSN
2210-7789
DOI
10.1016/j.preghy.2023.11.003
language
English
LU publication?
yes
additional info
Funding Information: We thank Maria Björklund (Library and ICT services, Lund University, Sweden) for designing and running the search strategies. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. Publisher Copyright: © 2023 The Authors
id
a383da25-700f-44cc-8fbe-a76a11806d94
date added to LUP
2023-12-21 10:58:26
date last changed
2024-04-19 20:30:20
@article{a383da25-700f-44cc-8fbe-a76a11806d94,
  abstract     = {{<p>Human chorionic gonadotropin (hCG), a glycoprotein produced in the placenta, is crucial for a healthy pregnancy. We investigated the relationship between hCG levels and adverse pregnancy outcomes. We conducted a systematic review including studies measuring hCG blood levels in the first or second trimester, reporting on any of the 12 predefined adverse pregnancy outcomes with logistic regression-adjusted association estimates. The primary outcomes were placenta-associated complications, such as miscarriage, preeclampsia, intrauterine growth restriction, and preterm delivery. We searched PubMed, Embase and CINAHL Complete. The hCG levels were analysed as multiple of the median (MoM). Odds ratio (OR) and 95% confidence interval (CI) were used. Risk of bias and the certainty of evidence were assessed using ROBINS-I and GRADE, respectively. Meta-analysis also showed that hCG levels, reported as MoM ≥2/2.31/2.5, might be associated with an increased risk of preeclampsia (OR 2.08, 95% CI 1.26 to 3.44) and preterm delivery (OR 1.29, 95% CI 1.12 to 1.47), but the evidence is very uncertain. High second trimester hCG levels may be associated with preeclampsia and preterm delivery but confidence in evidence is low.</p>}},
  author       = {{Skogler, Johannes and Moberg, Tilda and Tancredi, Luca and Styrmisdóttir, Lea and Hedayati, Ehsan and Alarcon-Ruiz, Christoper A. and Khamis, Assem and Persad, Emma and Iskandarani, Ghida and Hansson, Stefan R. and Bruschettini, Matteo}},
  issn         = {{2210-7789}},
  keywords     = {{hCG; Preeclampsia; Pregnancy complications}},
  language     = {{eng}},
  pages        = {{124--137}},
  publisher    = {{Elsevier}},
  series       = {{Pregnancy Hypertension}},
  title        = {{Association between human chorionic gonadotropin (hCG) levels and adverse pregnancy outcomes : A systematic review and meta-analysis}},
  url          = {{http://dx.doi.org/10.1016/j.preghy.2023.11.003}},
  doi          = {{10.1016/j.preghy.2023.11.003}},
  volume       = {{34}},
  year         = {{2023}},
}