Pregnancy outcomes in unselected singleton pregnant women with an increased risk of first-trimester Down's syndrome

Liu, Silvia So-Aei; Lee, Fa‐Kung; Lee, Jia-Ling; Tsai, Ming‐Song; Cheong, Mei‐Leng; She, Bo-Quing; Chen, Su-Chee

doi:10.1080/j.0001-6349.2004.00425.x

Cited by 12 publications

(19 citation statements)

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“…It is well accepted that low PAPP-A is associated with subsequent pregnancy loss (Ong et al, 2000;Yaron et al, 2002a;Kwik and Morris, 2003;Dugoff et al, 2004;Kabili et al, 2004;Liu et al, 2004). Our findings are compatible with these previous studies and demonstrated that a PAPP-A ≤0.3 MoM conveyed a significant risk of pregnancy loss almost five times greater than pregnancies with a PAPP-A >0.3 MoM.…”

Section: Low Papp-a and Adverse Outcomessupporting

confidence: 83%

“…The greatest risk for these women was an almost 5-fold increased risk of pregnancy loss (RR 4.9) with the risk of low birth weight and preterm birth being increased 1.8 and 1.6-fold respectively. These findings are somewhat similar to those of Liu et al (2004) who excluded chromosomal abnormalities and structural defects and found that screen positive pregnancies had a significantly higher risk of adverse outcomes than screen negative women. However, the adverse outcomes examined by Liu et al (2004) in 2284 pregnancies differed and included spontaneous abortion and placenta previa, which were increased in screen positive pregnancies.…”

Section: Screen Positive Fts and Adverse Outcomessupporting

confidence: 75%

“…These findings are somewhat similar to those of Liu et al (2004) who excluded chromosomal abnormalities and structural defects and found that screen positive pregnancies had a significantly higher risk of adverse outcomes than screen negative women. However, the adverse outcomes examined by Liu et al (2004) in 2284 pregnancies differed and included spontaneous abortion and placenta previa, which were increased in screen positive pregnancies. It is important to note this current study did not support the use of a positive FTS result for primary screening.…”

Section: Screen Positive Fts and Adverse Outcomessupporting

confidence: 75%

“…Low levels of PAPP-A may be an indicator of impaired placental function and implantation. It has been suggested that poor placentation could result in increased risk of poor outcome including pregnancy loss, premature birth and reduced birth (Dugoff et al, 2004;Liu et al, 2004).…”

Section: Low Papp-a and Adverse Outcomesmentioning

confidence: 99%

“…There has been a recent interest in the ability of the FTS to predict adverse outcomes other than Down syndrome Spencer et al, 2000;Spencer and Nicolaides, 2002;Liu et al, 2004;Yaron et al, 2004;O'Leary et al, 2006). Most literature has focused on the individual components of the screen; increased fetal NT (Adekunle et al, 1999;Souka et al, 2001;Cheng et al, 2004;Dugoff et al, 2004;Kabili et al, 2004;Krantz et al, 2004), low maternal PAPP-A (Ong et al, 2000;Ochshorn et al, 2001;Yaron et al, 2002a;Kwik and Morris, 2003;Dugoff et al, 2004;Kabili et al, 2004;Krantz et al, 2004) and abnormal free *Correspondence to: Sandie L. Barrett, Western Diagnostic Pathology, Symbion Health, Western Australia, Australia.…”

Section: Introductionmentioning

confidence: 99%

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Use of the combined first‐trimester screen result and low PAPP‐A to predict risk of adverse fetal outcomes

Barrett¹,

Bower

Hadlow³

2008

Prenatal Diagnosis

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ObjectivesTo investigate associations between combined first‐trimester screen result, pregnancy associated plasma protein‐A (PAPP‐A) level and adverse fetal outcomes in women.MethodsPregnancy outcomes for 10 273 women participating in a community based first‐trimester screening (FTS) programme in Western Australia were ascertained by record linkage to birth and birth defect databases. A first‐trimester risk cut‐off of ≥ 1 in 300 defined screen positive women.ResultsScreen positive pregnancies were more likely to have Down syndrome and birth defects (chromosomal or nonchromosomal) than screen negative pregnancies. When birth defects were excluded, screen positive pregnancies were at increased risk of pregnancy loss, low birth weight and preterm birth. Pregnancies with low PAPP‐A (⩽0.3 multiples of the median (MoM)) had higher risk of chromosomal abnormality, birth defect, preterm birth, low birth weight, or pregnancy loss, compared to those with PAPP‐A > 0.3 MoM. In pregnancies without birth defects, low PAPP‐A was a stronger predictor of preterm birth, low birth weight or pregnancy loss than a screen positive result.ConclusionsWomen with positive screen or low PAPP‐A were at increased risk for some adverse fetal outcomes. The sensitivity of these parameters was insufficient to support primary screening, but increased surveillance during pregnancy may be appropriate. Copyright © 2008 John Wiley & Sons, Ltd.

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Section: Low Papp-a and Adverse Outcomessupporting

confidence: 83%

Section: Screen Positive Fts and Adverse Outcomessupporting

confidence: 75%

Section: Screen Positive Fts and Adverse Outcomessupporting

confidence: 75%

Section: Low Papp-a and Adverse Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Use of the combined first‐trimester screen result and low PAPP‐A to predict risk of adverse fetal outcomes

Barrett¹,

Bower

Hadlow³

2008

Prenatal Diagnosis

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First‐trimester serum PAPP‐A and fβ‐hCG concentrations and other maternal characteristics to establish logistic regression‐based predictive rules for adverse pregnancy outcome

et al. 2010

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Objective To determine the clinical relevance of maternal characteristics and first-trimester serum concentrations of pregnancy-associated plasma protein A (PAPP-A) and free beta human chorionic gonadotrophin (fβ-hCG) in predicting placenta-related complications, miscarriage and preterm delivery. Methods By logistic regression, predictive rules were made based on PAPP-A and fβ-hCG concentrations, maternal smoking, maternal weight and age, low birth weight, stillbirth and hypertensive disorders, miscarriage and preterm birth. Predictive values were analysed with the area under the curve (AUC) of receiver operating curves (ROC). Design, Setting and PopulationResults Predictive for placenta-related complications were low PAPP-A, low fβ-hCG, smoking and weight (AUC 54%). For miscarriage low PAPP-A, low fβ-hCG and maternal age (MA) were predictive (AUC 78%) and for preterm delivery low PAPP-A, smoking, MA and maternal weight (AUC 55%).Conclusion Only the predictive model for miscarriage had a clinically relevant predictive value of 28%. Results together do not justify closer surveillance of chromosomally normal pregnancies with PAPP-A or fβ-hCG levels below the fifth percentile.

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Decreased PAPP-A is associated with preeclampsia, premature delivery and small for gestational age infants but not with placental abruption

Ranta

Raatikainen

Romppanen

et al. 2011

European Journal of Obstetrics & Gynecology and Reproductiv

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Pregnancy outcomes in unselected singleton pregnant women with an increased risk of first-trimester Down's syndrome

Cited by 12 publications

References 0 publications

Use of the combined first‐trimester screen result and low PAPP‐A to predict risk of adverse fetal outcomes

Use of the combined first‐trimester screen result and low PAPP‐A to predict risk of adverse fetal outcomes

First‐trimester serum PAPP‐A and fβ‐hCG concentrations and other maternal characteristics to establish logistic regression‐based predictive rules for adverse pregnancy outcome

Decreased PAPP-A is associated with preeclampsia, premature delivery and small for gestational age infants but not with placental abruption

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