Abstract
BackgroundTo identify the relationship between quadruple test for aneuploidy screening (alpha-fetoprotein: AFP; free beta-human chorionic gonadotropin: b-hCG; unconjugated estriol: uE3 and inhibin-A: IHA) and fetal growth restriction and to construct predictive models for small-for-gestational-age (SGA) fetuses.MethodsWomen who underwent quadruple test for aneuploidy were followed-up for final outcomes. The multiples of the median (MoMs) of the four biochemical markers for the SGA group and those of normal fetuses were compared. The models for predicting SGA by the individual biomarkers and their combination were constructed using binary logistic regression analysis, and their diagnostic performances in predicting SGA were determined.ResultsOf 10,155 eligible pregnant women, 578 (5.7%) and 9577 (94.3%) had SGA and normal growth, respectively. High levels of AFP, b-hCG and IHA but low levels of uE3 significantly increased the risk of SGA. The constructed predictive equations had predictive performance for SGA, with areas under the receiver-operated characteristic curve of 0.724, 0.655, 0.597, 0.664 and 0.754 for AFP, b-hCG, uE3, IHA, and the combination, respectively.ConclusionThe quad test for aneuploidy screening could also be used as a predictor of SGA, without extra-effort and extra-cost.
Highlights
To identify the relationship between quadruple test for aneuploidy screening and fetal growth restriction and to construct predictive models for small-for-gestational-age (SGA) fetuses
It is well established that racial factors strongly impact on serum marker levels [9,10,11,12,13], and the normative data of serum biomarkers derived from Caucasian women cannot accurately be interpreted when used in other parts of the world
Though several studies have linked abnormal serum marker levels to higher rate of SGA, no study provides objective methods or models derived from individual serum markers that can be clinically used to determine the probability of SGA
Summary
To identify the relationship between quadruple test for aneuploidy screening (alpha-fetoprotein: AFP; free beta-human chorionic gonadotropin: b-hCG; unconjugated estriol: uE3 and inhibin-A: IHA) and fetal growth restriction and to construct predictive models for small-for-gestational-age (SGA) fetuses. Small for gestational age (SGA), usually defined as fetuses with birthweight of less than the 10th percentile of the gestational age, is one of the common conditions of high-risk pregnancy, leading to poor pregnancy outcomes, such as perinatal morbidity and mortality as well as abnormal neurodevelopment. The main objectives are as follows: 1) To identify the relationship between second trimester serum markers or quadruple (quad) test, consisting of alpha fetoprotein (AFP), free betahuman chorionic gonadotrophin (b-hCG), unconjugated estriol (uE3), and inhibin-A (IHA), and the rate of SGA. The main objectives are as follows: 1) To identify the relationship between second trimester serum markers or quadruple (quad) test, consisting of alpha fetoprotein (AFP), free betahuman chorionic gonadotrophin (b-hCG), unconjugated estriol (uE3), and inhibin-A (IHA), and the rate of SGA. 2) In case of a significant relationship, the model predicting the risk of SGA is constructed
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