The following is a summary of “First and second-trimester biochemical serum markers in maternal familial Mediterranean fever: The impact of colchicine use,” published in the November 2023 issue of Obstetrics and Gynecology by Atalay, et al.
For a study, researchers sought to find out what happens to screen markers in the first and second trimesters of pregnancies complicated by familial Mediterranean fever (FMF) when women take colchicine. They also wanted to see how these effects affect the general results of these pregnancies. A case-control study was done in the past on pregnant women who had FMF and were taking colchicine, as well as healthy pregnant women who did not have any known risk factors or drug use. They measured biochemical markers for aneuploidy, such as AFP, HCG, and unconjugated estriol (uE3) in the second trimester and free ß-hCG and PAPP-A in the first trimester. They also compared the molecular levels of these markers between the FMF and control groups. Between groups, obstetric history and results were also looked at. They used propensity score matching to put together a group of patients who were alike at the start.
Out of the 93 expecting women who were qualified, 31 in the FMF group and 31 in the control group had similar propensity scores and were used in the studies. There was no difference in serum-free ß-hCG, PAPP-A, or AFP between the FMF and the control groups (p = 0.671, P = 0.387, and P = 0.963, respectively). Mothers in the FMF group who took colchicine had significantly lower levels of uE3 MoM in their blood during the second trimester compared to those who did not (P = 0.045). They also looked at how these markers changed based on the daily amount of colchicine in the different FMF categories. They didn’t find any big differences between the two ways of treating colchicine (0.5–1 mg/day vs. 1.5–2 mg/day, P > 0.05).
In the second trimester, FMF and colchicine may change the molecular markers in the mother’s blood that are used in an aneuploidy screening test. This could lead to a wrong understanding of the risk level of the tests. FMF and colchicine use should be considered a possible cause for these tests with lower uE3 levels after common causes and confounding factors have been ruled out. Only then should invasive diagnostic testing be suggested.
Source: sciencedirect.com/science/article/abs/pii/S2468784723001150