Efficacy of Mid-Second-Trimester Serum b-HCG Levels as a Predictor of Hypertensive Disorders of Pregnancy: A Longitudinal Cohort Study

Abstract

Introduction: Hypertensive Disorders of Pregnancy (HDP) affect up to 10% of pregnancies worldwide, despite improvements in maternal and neonatal care. HDP and its sequelae are a dreaded complication of pregnancy. If prediction becomes possible, prevention will follow naturally. Aim: To study the efficacy of mid-second trimester serum b-hCG levels in the prediction of HDP. Materials and Methods: This was a longitudinal cohort study conducted in the Department of Obstetrics and Gynaecology at Shri BM Patil Medical College Hospital and Research Centre , Vijayapura, Karnataka, India, between December 2020 and June 2022. All women with gestational age between 16-20 weeks were screened, and 163 pregnant women were enrolled in the study. Serum β-hCG levels were measured at enrollment, and values were followed-up until delivery. The development of HDP was evaluated using statistical analysis, including Chi-square, Independent t-test, Receiver Operating Curve/Area under the ROC Curve (ROC/AUC), sensitivity, and specificity. A p-value of <0.05 was considered significant. Results: Of the 163 pregnant women enrolled, 49 (30.1%) developed HDP, while 114 (69.9%) remained normotensive. The mean age of the study population was 24±4 years. The mean serum β-hCG level in the normotensive group was 55666 mIU/mL, while in the HDP group, it was 100124 mIU/mL, with a statistically significant p-value of 0.001. A cut-off value of 77817 mIU/mL showed 83.7% sensitivity and 92.1% specificity. Conclusion: This study suggests that serum b-hCG levels between 16-20 weeks can be used as a non-invasive predictor of HDP. It is a good predictor of HDP and could potentially improve prevention strategies.