The Relationship of Pregnancy-Associated Plasma Protein A and Human Chorionic Gonadotropin with Adverse Pregnancy Outcomes: A Prospective Study

bstract Purpose: This prospective study investigated the relationship between pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotropin (hCG) and adverse pregnancy outcomes in the Iranian population. Materials: Overall, 994 singleton pregnant mothers of 18-35-year old were referred for first-trimester screening tests, including PAPP-A and β-hCG, at the age of 6 days and 11-13 weeks, and were followed until the end of their pregnancy. The adverse pregnancy outcomes, PAPP-A, and β-hCG serum levels were recorded and analyzed. The sensitivity and specificity of the test were measured by calculating the area under the curve of receiver operating characteristic curve (ROC). Results: The mean serum level of PAPP-A and β-hCG was 1.10 ± 0.69 and 1.09 ± 0.8 MoM, respectively. Pregnancy-associated plasma protein A, regardless of its percentile, showed a significant relationship with the incidence of preeclampsia, preterm birth, and fetal low birth weight (p 0.05). According to ROC, the results indicated that PAPP-A had a significant relationship with the incidence of preeclampsia, preterm birth, and fetal low birth weight (p < 0.001). However, β-hCG levels showed no significant relationship with adverse pregnancy outcomes. Conclusions: The result of this study revealed that lower level of PAPP-A and β-hCG could be a predictive factor in preterm labor. Also, this study indicated that PAPP-A measurements could be a screening test for adverse pregnancy outcomes, such as preeclampsia, low birth weight and preterm labor

Effect of Vaginal Progesterone and Dydrogesterone on Pregnancy Outcomes in patients with Threatened Abortion: A Randomized Clinical Trial

Introduction: Despite the positive evidence on the effect of progesterone on protection of pregnancy in patients with threatened abortion, the results of studies regarding its drug type have been controversial. This study was performed with aim to compare the effect of vaginal progesterone and dydrogesterone on pregnancy outcome in cases with threatened abortion. Methods: In this single-blind randomized clinical trial, 160 pregnant women with threatened abortion who referred to Qazvin Kowsar Hospital in 2018 were randomly assigned to receive dydrogesterone (Duphaston) 10 mg twice daily or vaginal progesterone (Cyclogest) 400 mg daily. Finally, pregnancy outcomes were compared between the two groups. Data were analyzed by SPSS software (version 18) and Chi-square, independent t-test and Mann-Whitney tests. P<0.05 was considered statistically significant. Results: Frequency of cesarean section was 27 (33.7%) in the dydrogesterone group and 25 (31.2%) in the vaginal progesterone group (P = 0.736). In general, the incidence of preterm labor was 97 (60.6%) and there was no significant difference between the two groups (P >0.05). In addition, incidence of preeclampsia, gestational diabetes mellitus, placenta previa and intrauterine fetal death as well as neonatal weight were not significantly different between the two groups (P >0.05). Finally, maternal and neonatal complications showed no significant difference between the two groups (P = 0.675). Conclusion: Pregnancy outcomes after administration of dydrogesterone are not different with vaginal progesterone in the treatment of threatened abortion

Evaluation of Pregnancy consequences in Women with Polycystic Ovary Syndrome: A Case-Control Study in Qazvin, Iran

ABSTRACT Background and Aim: Polycystic ovary syndrome (PCOS) is a common disorder in women of childbearing age that can be associated with adverse pregnancy complications. The aim of this study was to compare the adverse pregnancy consequences between pregnant women with PCOS and control group in Qazvin. Materials and Methods: In this study, 150 pregnant women with PCOS aged 18-35 years with gestational age of more than 20 weeks were selected as our case group based on Rotterdam criteria and our control group included 150 pregnant women without PCOS. The groups were compared in terms of pregnancy complications including gestational diabetes, preeclampsia, preterm delivery, low birth weight, and neonatal admission to the neonatal intensive care unit (NICU). Results: There were no significant differences between the two groups in terms of demographic data including age, weight, height and BMI. In the case group (PCOS) we found gestational diabetes in 33 cases (64.7%) (P=0.021), preeclampsia in 44 cases (67.7%) (P=0.002), and preterm delivery 70 in cases (75.3%) which indicated a significant difference between the case and control groups (P<0.0001). The case group had higher neonatal complications than control group in regard to low birth weight (40 cases, 64.5%, P=0.008) and NICU admission (30 cases, 66.7%, P=0.015). Conclusion: The results of this study showed that PCOS, due to its metabolic effects, may increase the incidence of gestational diabetes, preeclampsia, preterm delivery, low birth weight or macrosomia and long term NICU admission. Keywords: Polycystic ovary syndrome, Premature birth, Gestational diabetes, Pre-eclampsi

Evaluation of Pregnancy consequences in Women with Polycystic Ovary Syndrome: A Case-Control Study in Qazvin, Iran

Background and Aim: Polycystic ovary syndrome (PCOS) is a common disorder in women of childbearing age that can be associated with adverse pregnancy complications. The aim of this study was to compare the adverse pregnancy consequences between pregnant women with PCOS and control group in Qazvin. Materials and Methods: In this study, 150 pregnant women with PCOS aged 18-35 years with gestational age of more than 20 weeks were selected as our case group based on Rotterdam criteria and our control group included 150 pregnant women without PCOS. The groups were compared in terms of pregnancy complications including gestational diabetes, preeclampsia, preterm delivery, low birth weight, and neonatal admission to the neonatal intensive care unit (NICU). Results: There were no significant differences between the two groups in terms of demographic data including age, weight, height and BMI. In the case group (PCOS) we found gestational diabetes in 33 cases (64.7%) (P=0.021), preeclampsia in 44 cases (67.7%) (P=0.002), and preterm delivery 70 in cases (75.3%) which indicated a significant difference between the case and control groups (P<0.0001). The case group had higher neonatal complications than control group in regard to low birth weight (40 cases, 64.5%, P=0.008) and NICU admission (30 cases, 66.7%, P=0.015). Conclusion: The results of this study showed that PCOS, due to its metabolic effects, may increase the incidence of gestational diabetes, preeclampsia, preterm delivery, low birth weight or macrosomia and long term NICU admission. Keywords: Polycystic ovary syndrome, Premature birth, Gestational diabetes, Pre-eclampsi