OP08.10: Modification of free-beta HCG and PAPP-A MoM in women with a previous miscarriage

Free-beta HCG and PAPP-A may be modified by a series of well-defined factors. We speculated that free-beta HCG and PAPP-A may be modified by a previous miscarriage. We enrolled 1253 consecutive Caucasian women requesting a first trimester combined risk, from August 2014 to March 2016. We included only singleton spontaneous pregnancies of healthy women. Gestational diseases and fetal major disorders, including abnormal karyotype, were excluded at follow-up. During the screening, information about previous miscarriages were included in the dataset. We individualised two groups of women: 767 who did not have any miscarriage and 486 who had at least one miscarriage. The two groups were homogeneous for baseline characteristics. Women who had experienced a previous miscarriage had a higher statistically significant value of PAPP-A MoM than women without previous miscarriage (1.46 ± 0.85 vs 1.33 ± 0.75 p 0.012). Free-beta HCG (44.1 ± 31 IU/L vs 46.8 ± 34.4 IU/L p 0.4), free-beta HCG MoM (1.05 ± 0.69 vs 1.10 ± 0.77 p 0.295) and PAPP-A (4.08 ± 2.68 IU/L vs 3.9 ± 2.50 IU/L p 0.337) were not significantly different in the two groups. Previous miscarriage may influence PAPP-A MoM and it should be reported in collecting data. However, further study is necessary to understand the causative association described in this abstract. We need larger series to produce likelihood ratios to apply in a screening setting in case of a previous miscarriage.