Association of maternal exposure to bisphenol A with her β-hCG level and neonatal anthropometric measures

Bisphenol A (BPA) is one of the organic compounds that might interfere with estrogenic receptors, which would make difficulties in pregnancy hormones and fetal growth. Human chorionic gonadotropin (β-hCG) is one of the important pregnancy hormones that might be affected by environmental pollutants. The aim of this study is to investigate the probable impacts of maternal exposure to BPA on anthropometric measures of newborns. This cross-sectional study was conducted in 2019-2020 in Isfahan, Iran. During the first trimester of pregnancy, we measured the urinary BPA concentration and serum β-hCG level of 120 pregnant women, who were randomly selected from participants of a birth cohort. BPA concentration was measured using gas chromatography-mass spectrometry (GC-MS). Serum blood sample was derived and used for β-hCG analysis. Anthropometric measurement of neonates was conducted at the time of birth. BPA and β-hCG level were grouped by quartiles, and their associations with birth weight, height, and head circumference were tested using multiple linear regression model. The adjustment was done for urine creatinine, gender, and gestational age, as well as maternal age, body mass index, and education level. Data of 119 pairs of mothers and infants were available for the present study. The mean (SD) age of mothers was 29.19 (5.75) years; 56.3% of newborns were boys. Geometric mean of urinary BPA and β-hCG concentrations were 0.36 ng/g crea. (creatinine) and 17736 mIU/ml, respectively. Across the BPA tertiles, the differences in mean values were not significant for none of the anthropometric measurements and gestational age (GA). Furthermore, no significant association existed between unadjusted and adjusted tertiles of BPA and β-hCG with abovementioned birth outcomes. It seems that the non-significant association found in this study is because of low levels of urinary BPA levels than in other studies; the adverse effects on infants might be related to high concentration of BPA passed from placenta. Future longitudinal studies with large sample size are necessary to document the adverse health effects of maternal exposure to endocrine disruptor chemicals including BPA.

Evaluation of indications for amniocentesis in cases of normal fetal ultrasound results

OBJECTIVES

The objective of this study was to analyze indications for amniocentesis in cases of patients with normal fetal ultrasound results between 11+0 and 13+6 weeks of gestation.

MATERIAL AND METHODS

The results of first-trimester screening tests performed between 2014 and 2018 on 6,863 patients of the Prenatal Testing Outpatient Clinic at the Clinical Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland, were analyzed. The inclusion criteria were a singleton pregnancy and normal results of fetal ultrasound between 11+0- and 13+6-weeks' gestation. Depending on the calculated risk of fetal trisomy 21, the patients were divided into three groups (group A = RS > 1:300, group B = RS 1:300 - 1:999, group C = RS ≤ 1:1000). Subsequently, values such as PAPP-A and fβ-hCG protein levels and maternal age were analyzed for each of the groups.

RESULTS

The patients, 6,310 (91.94%) met the inclusion criteria. A high risk of fetal trisomy 21 was identified for 514 women (8.15%). Group B had 733 (11.62%) and group C 5,063 (80.23%) patients. In group A, an fβ-hCG level of ≥ 2.000 MoM was shown for 50.97% of the women. A PAPP-A level ranging from 0.001 to 0.499 MoM was observed for 38.72% of group A patients. The mean maternal age in groups A, B and C was 36.45, 36.08 and 31.64 years, respectively.

CONCLUSIONS

In the first-trimester, patients with normal ultrasound results obtained during prenatal screening tests, the main cause of an increased risk of trisomy 21 was elevated PAPP-A and fβ-hCG concentrations. According to this paper's authors, in these cases extension of diagnosis to include other gestational complications, e.g. preeclampsia, should be considered.

Amenorrhea and elevated βhuman chorionic gonadotropin of unknown origin: An unexpected location of choriocarcinoma

Choriocarcinoma is a rare malignancy originating from trophoblastic cells that is known to arise from the placenta. In this report, we describe the case of a 28-year-old female who consulted for amenorrhea and elevated βhCG mimicking a pregnancy of an unknown location, which ultimately turned out to be primary choriocarcinoma of the lung.

CT measurement of breast glandular tissue and its association with testicular cancer

OBJECTIVES

To evaluate the associations between breast glandular tissues diameters as determined by CT and b-hCG levels, histological types, tumour spread and prognosis in patients with testicular germ cell tumour.

METHODS

Ninety-four patients with pre-treatment CT scan and markers (b-hCG, AFP, LDH) were retrospectively collected. A radiologist measured diameters in all CT examinations and correlation between diameters and log (b-hCG) was assessed (Pearson's coefficient). The ability of measured diameters to predict lymphatic and distant haematogenous metastatic spread was evaluated (ROC curves). The associations between measured diameter cut-off values of 20 and 25 mm and International Germ Cell Cancer Collaborative Group (IGCCCG) classification, lymphatic and distant haematogenous metastatic spread and histological subtypes were evaluated (chi squared test).

RESULTS

Breast glandular diameters correlated to log(b-hCG) (r = 0.579) and predicted distant haematogenous metastatic spread (AUC = 0.78). Worse prognosis (intermediate or poor IGCCCG) was shown for 20 mm (27.3 vs. 4.2 %, p = 0.005) and 25 mm (33.3 vs. 6.1 %, p = 0.014). A diameter of 25 mm was associated with non-seminoma (91.7 vs. 48.8 %, p = 0.005).

CONCLUSION

Breast glandular tissue diameters correlated with log(b-hCG) and predicted distant haematogenous metastases. Twenty and 25 mm were associated with worse prognosis and 25 mm was able to distinguish between seminoma and non-seminoma.

KEY POINTS

• CT breast glandular tissue diameter correlates with log(b-HCG) • Gynaecomastia in CT is associated with worse prognosis • Gynaecomastia in CT is associated with non-seminoma histological subtype.