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Obstet Gynecol. Author manuscript; available in PMC 2017 September 01. Published in final edited form as: Obstet Gynecol. 2016 September ; 128(3): 504–511. doi:10.1097/AOG.0000000000001568.
Differences in Serum Human Chorionic Gonadotrophin Rise in Early Pregnancy by Race and Value at Presentation Kurt T Barnhart, MD, MSCE1,2, Wensheng Guo, PhD2, Mark S Cary, PhD2, Chris Morse, MD1, Karine Chung, MD, MSCE3, Peter Takacs, MD, PhD4, Suneeta Senapati, MD, MSCE1, and Mary D Sammel, ScD1,2 1Department
of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
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2Department
of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
3Department
of Obstetrics and Gynecology, University of Southern California Keck School of Medicine, Los Angeles, CA
4Department
of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, FL
Abstract Objective—To assess whether variation in serum human chorionic gonadotropin (hCG) measures, used to assess early gestation viability, are associated with differences in clinical presentation and patient factors.
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Method—This retrospective cohort study included 285 women with first-trimester pain and bleeding and a pregnancy of unknown location, for whom a normal intrauterine pregnancy was ultimately confirmed. Serial samples were collected at three U.S. sites and hCG changes were analyzed for differences by race, ethnicity and clinical factors. A nonlinear, mixed effects regression model was used assuming a random subject shift in the time axis.
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Results—The hCG rise in symptomatic women with ongoing intrauterine pregnancy differs by patient factors, and level at presentation. The 2-day minimum (1st percentile) rise in hCG was faster when presenting hCG values were low and slower when presenting hCG value was high. African American had a faster hCG rise (p