Chorionic Villus Sampling at 11 to 13 Weeks of Gestation and Hypertensive Disorders in Pregnancy

摘要

OBJECTIVE: To estimate the potential association of chorionic villus sampling (CVS) with subsequent development of hypertensive disorders of pregnancy and to evaluate whether any such potential association remains significant after adjusting for maternal characteristics and components of first-trimester screening. METHODS: We included live singleton pregnancies at 11 0/7 to 13 6/7 weeks surviving to beyond 23 weeks of gestation with available measurements of free beta-hCG and pregnancy-associated plasma protein A. We excluded pregnancies resulting in miscarriage or termination before 24 weeks of gestation, women with no known pregnancy outcome, and women who had an amniocentesis. Multiple logistic regression analysis was used to determine whether CVS, in addition to factors in the maternal history and characteristics, made a significant contribution to the development of preeclampsia and gestational hypertension. RESULTS: Included in the study were 31,138 women, of whom 697 (2.2%) had preeclampsia subsequently develop, and 857 (2.8%) had gestational hypertension develop. In 2,278 (7.3%) individuals, a CVS was performed. Multiple logistic regression analysis demonstrated that although there were significant contributions from maternal factors and serum biochemistry, a CVS in the first trimester did not contribute significantly to subsequent development of early preeclampsia (P = .677), late preeclampsia (P = .535), or gestational hypertension (P = .848). CONCLUSION: There is no association between performing a CVS in the first trimester and subsequent development of hypertensive disorders of pregnancy.