ABSTRACT
Aim: To develop preeclampsia (PE) risk prediction model based on maternal characteristics and
serum markers at the first and second trimester in the twin pregnancy.
Methods: Between January 2005 and September 2017, we retrospectively reviewed medical
records of 532 twin pregnant women who underwent maternal serum integrated test and gave
birth at a Bundang CHA Medical Center. Maternal serum pregnancy-associated plasma protein A
(PAPP-A) was determined at 10þ0 to 13þ6 weeks and the serum alpha-fetoprotein (MSAFP),
human chorionic gonadotrophin (hCG), unconjugated estriol (uE3) and inhibin A were assayed
at 14þ0 to 22þ0weeks. We assessed the relationships of maternal characteristics and serum
markers by using multiple logistic regression analysis.
Results: The study included 35 patients who diagnosed PE and a control group consisting of
the other 497 patients in twin pregnancy. There were no significant differences in the maternal
age and body mass index (BMI) between two groups. However, the gestational age and placenta
weight at delivery were significantly different between groups (p<.001, p¼.005, respectively.
Among the maternal serum markers, inhibin A value was significantly higher in women
with PE compared to those without preeclampsia (p<.001). In addition, we predicted the PE
using maternal age, BMI, uE3, and inhibin A which were achieving an area under the curve of
0.73 overall in twin pregnancy.
Conclusion: A risk prediction model of PE which combined maternal age, BMI, uE3, and inhibin
A was better early predictors than any individual marker twin pregnancy