4.4 Article

Impact of clinical characteristics on human chorionic gonadotropin regression after molar pregnancy

Journal

CLINICS
Volume 76, Issue -, Pages -

Publisher

HOSPITAL CLINICAS, UNIV SAO PAULO
DOI: 10.6061/clinics/2021/e2830

Keywords

Gestational Trophoblastic Disease; Chorionic Gonadotropin; Molar Pregnancy

Funding

  1. Dyett Family Trophoblastic Disease Research and Registry Endowment

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This study found that age and race/ethnicity did not affect hCG regression rates, while obesity and hormonal contraceptive use were associated with faster hCG regression rates, although clinically insignificant. Understanding how clinical characteristics may influence hCG regression curve is important for predicting the risk of gestational trophoblastic neoplasia.
OBJECTIVES: This study aimed to determine the effects of age, race/ethnicity, body mass index, and contraception on human chorionic gonadotropin (hCG) regression following the evacuation of a molar pregnancy. METHODS: This was a retrospective cohort study of 277 patients with molar pregnancies between January 1, 1994 and December 31, 2015. The rate of hCG regression was estimated using mixed-effects linear regression models on daily log-transformed serum hCG levels after evacuation. RESULTS: There were no differences in hCG half-lives among age (p=0.13) or race/ethnicity (p=0.16) groups. Women with obesity and hormonal contraceptive use demonstrated faster hCG regression than their counterparts (3.2 versus. 3.7 days, p=0.02 and 3.4 versus. 4.0 days, p=0.002, respectively). CONCLUSION: Age and race/ethnicity were not associated with hCG regression rates. Hormonal contraceptive use and obesity were associated with shorter hCG half-lives, but with unlikely clinical significance. It is important to understand whether the clinical characteristics of patients may influence the hCG regression curve, as it has been proposed as a way to predict the risk of gestational trophoblastic neoplasia.

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