Erschienen in:
11.03.2016 | Original Article
Maternal Serum Aneuploidy Screen and Adverse Pregnancy Outcomes
verfasst von:
Koumudi Godbole, Aparna Kulkarni, Asawari Kanade, Shilpa Kulkarni, Girish Godbole, Anuradha Wakankar
Erschienen in:
The Journal of Obstetrics and Gynecology of India
|
Sonderheft 1/2016
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Abstract
Objective
To find out whether maternal serum screening for fetal chromosomal aneuploidy predicts adverse pregnancy outcomes.
Methods
A two-year retrospective case–control study was conducted at a tertiary hospital. Pregnant women with a high-risk serum screen but with chromosomally normal fetuses (n = 189) were compared to those with low-risk screen (controls, n = 157) for adverse pregnancy outcomes.
Results
Women with high-risk double marker or combined screen were found to have higher prevalence of LBW [OR 2.56; 95 % CI (1.01–6.53), p < 0.05] and PT [OR 2.93; 95 % CI (1.11–7.65), p < 0.05], while women with high-risk triple screen had higher prevalence of PIH [OR 3.72; 95 % CI (1.23–11.18); p < 0.05], Oligo [OR 4.50; 95 % CI (1.30–15.64); p < 0.05], delivery by C-section [OR 2.51; 95 % CI (1.41–4.47); p < 0.005] as compared to low-risk women. PAPP-A was found to be a significant predictor of birth weight (R
2 = 12.2 %, β ± SE = 0.224 ± 0.069; p < 0.005) and gestational age (R
2 = 4.9 %, β ± SE = 0.613 ± 0.296; p < 0.05). Beta hCG in first and hCG in second trimester predicted oligohydramnios (R
2 = 9.2 %, β ± SE = −0.077 ± 0.025; p < 0.005). The areas under the ROC curves of PAPP-A for LBW and PT were 0.70(p < 0.01) and 0.684 (p < 0.05), respectively.
Conclusion
A “high-risk” maternal serum screen with abnormal PAPP-A and/or beta hCG/HCG is associated with adverse pregnancy outcomes and may help identifying women requiring additional fetal surveillance.