| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
ORIGINAL RESEARCH |
From the University of Colorado Health Sciences Center, Denver, Colorado; Columbia University, College of Physicians and Surgeons, New York, New York; DMSTAT, Boston, Massachusetts; Brown University School of Medicine, Providence, Rhode Island; University of Utah and Intermountain HealthCare, Salt Lake City, Utah; Swedish Medical Center, Seattle, Washington; William Beaumont Hospital, Royal Oak, Michigan; University of Texas Medical Branch, Galveston, Texas; Mount Sinai School of Medicine, New York, New York; Albert Einstein College of Medicine, New York, New York; Tufts University School of Medicine, Boston, Massachusetts; New York University, New York, New York; and University of North Carolina Medical Center Chapel Hill, North Carolina.
Objective: To estimate the effect of second-trimester levels of maternal serum alpha-fetoprotein (AFP), human chorionic gonadotrophin (hCG), unconjugated estriol (uE3), and inhibin A (the quad screen) on obstetric complications by using a large, prospectively collected database (the FASTER database).
Methods: The FASTER trial was a multicenter study that evaluated first- and second-trimester screening programs for aneuploidy in women with singleton pregnancies. As part of this trial, patients had a quad screen drawn at 15–18 6/7 weeks. We analyzed the data to identify associations between the quad screen markers and preterm birth, intrauterine growth restriction, preeclampsia, and fetal loss. Our analysis was performed by evaluating the performance characteristics of quad screen markers individually and in combination. Crude and adjusted effects were estimated by multivariable logistic regression analysis. Patients with fetal anomalies were excluded from the analysis.
Results: We analyzed data from 33,145 pregnancies. We identified numerous associations between the markers and the adverse outcomes. There was a relatively low, but often significant, risk of having an adverse pregnancy complication if a patient had a single abnormal marker. However, the risk of having an adverse outcome increased significantly if a patient had 2 or more abnormal markers. The sensitivity and positive predictive values using combinations of markers is relatively low, although superior to using individual markers.
Conclusion: These data suggest that components of the quad screen may prove useful in predicting adverse obstetric outcomes. We also showed that the total number and specific combinations of abnormal markers are most useful in predicting the risk of adverse perinatal outcome.
Level of Evidence: II-2
This article has been cited by other articles:
|
|
 |
|
  R. Bukowski, T. Uchida, G. C. S. Smith, F. D. Malone, R. H. Ball, D. A. Nyberg, C. H. Comstock, G. D. V. Hankins, R. L. Berkowitz, S. J. Gross, et al. Individualized Norms of Optimal Fetal Growth: Fetal Growth Potential Obstet. Gynecol., May 1, 2008; 111(5): 1065 - 1076. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. M. Reddy Prediction and Prevention of Recurrent Stillbirth Obstet. Gynecol., November 1, 2007; 110(5): 1151 - 1164. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. J. Mizejewski Physiology of Alpha-Fetoprotein as a Biomarker for Perinatal Distress: Relevance to Adverse Pregnancy Outcome Experimental Biology and Medicine, September 1, 2007; 232(8): 993 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Y. Spong Prediction and Prevention of Recurrent Spontaneous Preterm Birth Obstet. Gynecol., August 1, 2007; 110(2): 405 - 415. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
