Maternal Serum Aneuploidy Screen and Adverse Pregnancy Outcomes

Godbole, Koumudi; Kulkarni, Aparna; Kanade, Asawari; Kulkarni, S.; Godbole, Girish; Wakankar, Anuradha

doi:10.1007/s13224-015-0826-2

Cited by 8 publications

(8 citation statements)

References 24 publications

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“…An increased risk of pregnancy complications, such as pre-eclampsia, stillbirth, preterm birth and SGA, has been found previously after a false-positive high-risk result on first-and second-trimester aneuploidy screening [8][9][10][11][12] . The findings of our study extend this association to women with a false-positive high or intermediate risk for aneuploidy and suggest that, in these women, further screening for SGA may increase the detection rate of fetal-growth disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, advanced maternal age (≥ 35 years at the time of delivery) is associated not only with an increased risk of fetal chromosomal abnormality 25 , but is also reported invariably as an independent risk factor for SGA/FGR [26][27][28] . While elevated levels of free β-hCG have not been found to be associated with delivery of a SGA neonate 29,30 , low PAPP-A level has been described widely in connection with a broad range of adverse perinatal outcomes including SGA 9,10,31,32 . Pylypjuk and Monárrez-Espino 33 found no association between a false-positive result for aneuploidy and FGR, but their study analyzed only maternal serum tests without a combined algorithm.…”

Section: Discussionmentioning

confidence: 99%

“…For several decades, it has been known that one in three women with a false-positive high-risk result (> 1/100) for Down syndrome may experience adverse pregnancy outcome 8 . A limited number of studies [9][10][11][12] have shown exceedingly high rates of small-for-gestational age (SGA) fetuses and fetal growth restriction (FGR) among women with a false-positive result on screening for chromosomal abnormality, due to an association between abnormal maternal serum markers and low birth weight. One might expect this association to be present also in intermediate-risk cases, but no research has been done in this group.…”

Section: Introductionmentioning

confidence: 99%

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First‐trimester prediction of small‐for‐gestational age in pregnancies at false‐positive high or intermediate risk for fetal aneuploidy

Yarygina

Bataeva

Benitez

et al. 2020

Ultrasound in Obstet & Gyne

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Objectives To explore the risk of small‐for‐gestational age (SGA) and fetal growth restriction (FGR) and to test the performance of first‐trimester screening for SGA and FGR in women with a false‐positive high or intermediate risk for aneuploidy. Methods This was a prospective cohort study of women with a singleton pregnancy attending for a routine first‐trimester scan. The risks of aneuploidy and preterm SGA (defined as birth weight < 10th percentile with delivery before 37 weeks) were determined according to Fetal Medicine Foundation algorithms. In non‐malformed euploid pregnancies, the predictive performance of both the aneuploidy and preterm SGA risks was evaluated for SGA, FGR (defined as birth weight < 3rd centile), preterm SGA and early SGA (delivery before 34 weeks), using receiver‐operating‐characteristics (ROC) curve analysis, in those with a high or intermediate risk of aneuploidy and in the overall population. Results A total of 2053 pregnancies were included in the analysis, of which 191 (9.3%) were at high or intermediate risk for aneuploidy (≥ 1/1000) and 304 (14.8%) were at high risk for preterm SGA (≥ 1/100). In total, there were 140 (6.8%) cases of SGA, 61 (3.0%) of FGR, 44 (2.1%) of preterm SGA and 33 (1.6%) of early SGA. Among women with a false‐positive high or intermediate risk for aneuploidy, the rates of SGA, FGR, preterm SGA and early SGA were 13.6% (26/191), 7.9 % (15/191), 6.8% (13/191) and 5.8% (11/191), respectively. Compared with women with a first‐trimester low risk for preterm SGA, regardless of aneuploidy risk, those with a high risk for preterm SGA and a high or intermediate risk for aneuploidy had relative risks for SGA, FGR, preterm SGA and early SGA of 6 (95% CI, 3.9–9), 9.2 (95% CI, 5.1–16.5), 13.4 (95% CI, 6.9–26.1) and 17.6 (95% CI, 8.1–38.2), respectively. The predictive performance for SGA of the preterm SGA algorithm was higher in women at high or intermediate risk for aneuploidy than in the overall population (area under the ROC curve (AUC), 0.8 vs 0.7; P < 0.001). Among women at high or intermediate risk for aneuploidy, the predictive performance of the preterm SGA algorithm was better than that of the aneuploidy algorithm for SGA (AUC, 0.80 vs 0.58; P = 0.003), preterm SGA (AUC, 0.85 vs 0.65; P = 0.013) and early SGA (AUC, 0.86 vs 0.60; P = 0.002). Conclusion In women with a first‐trimester false‐positive high or intermediate risk of aneuploidy, further screening for SGA allows stratification of the risk for fetal growth disorders. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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First‐trimester prediction of small‐for‐gestational age in pregnancies at false‐positive high or intermediate risk for fetal aneuploidy

Yarygina

Bataeva

Benitez

et al. 2020

Ultrasound in Obstet & Gyne

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“…Some studies have reported the potential usability of maternal biomarkers from fetal aneuploidy screening tests in predicting adverse pregnancy outcomes 16 , 17 . Particularly, one such biomarker estrogen produced in the placenta has been suggested to have a normal endocrine effect during pregnancy and maternal estrogen levels at delivery were found to be significantly and positively correlated with neonatal birth weight 18 , 19 .…”

Section: Introductionmentioning

confidence: 99%

Predictability of Macrosomic Birth based on Maternal Factors and Fetal Aneuploidy Screening Biochemical Markers in Hyperglycemic Mothers

et al. 2021

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Background: Macrosomic birth weight has been implicated as a significant risk factor for developing various adult metabolic diseases such as diabetes mellitus and coronary heart diseases; it has also been associated with higher incidences of complicated births. This study aimed to examine the predictability of macrosomic births in hyperglycemic pregnant women using maternal clinical characteristics and serum biomarkers of aneuploidy screening performed in the first half of pregnancy. Methods: A retrospective observational study was performed on a cohort of 1,668 pregnant women who 1) had positive outcomes after undergoing 50-g oral glucose challenge test (OGCT) at two university-based hospitals and 2) underwent any one of the following maternal biomarker screening tests for fetal aneuploidy: triple test, quadruple test, and integrated test. Logistic regression-based models for predicting macrosomic births using maternal characteristics and serum biomarkers were developed and evaluated for prediction power. A nomogram, which is a graphical display of the best predictable model, was then generated. Results: The study cohort included 157 macrosomic birth cases defined as birth weight ≥3,820 g, which was equivalent to the top 10 percentile of the modeling cohort. Three primary models solely based on serum biomarkers achieved area under curves (AUCs) of 0.55-0.62. Expanded models, including maternal demographic and clinical factors, demonstrated an improved performance by 25% (AUCs, 0.69-0.73). Conclusion:Our prediction models will help to identify pregnancies with an elevated risk of macrosomic births in hyperglycemic mothers using maternal clinical factors and serum markers from routine antenatal screening tests. Prediction of macrosomic birth at mid-pregnancy may allow customized antenatal care to reduce the risk of macrosomic births.

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“…A few reviews have attempted to summarize the risks associated with single serum marker aberrations or random combinations of markers, but due to the heterogeneity of these studies and their respective patient populations, the results are inconsistent [21][22][23]; variable cut-offs of individual serum markers or random combinations of markers also limit the clinical application of such fundings. Furthermore, many of the individual studies were small and underpowered to adequately assess risk for some of these rarer adverse pregnancy outcomes [9,[24][25][26]. Placentally mediated complications of pregnancy (preeclampsia, fetal growth restriction, preterm birth, and stillbirth) confer considerable risk for mothers and newborns worldwide.…”

Section: Introductionmentioning

confidence: 99%

False-Positive Maternal Serum Screens in the Second Trimester as Markers of Placentally Mediated Complications Later in Pregnancy: A Systematic Review and Meta-Analysis

Pylypjuk

Monárrez‐Espino

2021

Disease Markers

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Background. Multiple-marker, maternal serum screening (MSS) has been the cornerstone of prenatal diagnosis since the 1980s. While combinations of these markers are used to predict fetal risk of Down syndrome and other genetic conditions, there is some evidence that individual markers may also predict nongenetic pregnancy complications, particularly those related to placental dysfunction. The objective of this meta-analysis was to investigate the utility of false-positive, second-trimester MSS for Down syndrome as a marker of placentally mediated complications amongst singleton pregnancies globally. Methods. Electronic searches of PubMed, Medline, Embase, CINAHL, Web of Science, Scopus, and grey literature to 2019 were performed to identify observational studies comparing risk of pregnancy complications amongst pregnancies with false-positive MSS versus controls. A random-effects model of pooled odds ratios by outcome of interest (stillbirth, preeclampsia, fetal growth restriction, and preterm birth) and subgrouped by type of MSS test (double-, triple-, and quadruple-marker MSS) was used. Results. 16 studies enrolling 68515 pregnancies were included. There were increased odds of preeclampsia (OR 1.28, 95% CI 1.09-1.51) and stillbirth (OR 2.46, 95% CI 1.94-3.12) amongst pregnancies with false-positive MSS. There was no significant association with preterm birth or growth restriction. Conclusions. There is some evidence of an association between false-positive, second-trimester MSS for Down syndrome and increased odds of preeclampsia and stillbirth. Future large-scale prospective studies are still needed to best determine the predictive value of false-positive MSS as a marker of placentally mediated complications later in pregnancy and evaluate potential clinical interventions to reduce these risks.

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Maternal Serum Aneuploidy Screen and Adverse Pregnancy Outcomes

Cited by 8 publications

References 24 publications

First‐trimester prediction of small‐for‐gestational age in pregnancies at false‐positive high or intermediate risk for fetal aneuploidy

First‐trimester prediction of small‐for‐gestational age in pregnancies at false‐positive high or intermediate risk for fetal aneuploidy

Predictability of Macrosomic Birth based on Maternal Factors and Fetal Aneuploidy Screening Biochemical Markers in Hyperglycemic Mothers

False-Positive Maternal Serum Screens in the Second Trimester as Markers of Placentally Mediated Complications Later in Pregnancy: A Systematic Review and Meta-Analysis

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