Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: a population-based study
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(2020) 20:621
RESEARCH ARTICLE
Open Access
Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: a population-based study Rakchanok Boonpiam, Chanane Wanapirak, Supatra Sirichotiyakul, Ratanaporn Sekararithi, Kuntharee Traisrisilp* and Theera Tongsong
Abstract Background: 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. Methods: Women 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. Results: Of 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. Conclusion: The quad test for aneuploidy screening could also be used as a predictor of SGA, without extra-effort and extra-cost.
Background 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. Also, it can increase poor maternal outcomes, such as higher rate of cesarean section, maternal depression,higher cost of antenatal and postnatal care, etc. The incidence of SGA in developing countries varies from 6 to 30% of live births [1], * Correspondence: [email protected] Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
depending on the definition and criteria for diagnosis. Recently, many techniques have been developed to achieve early detection of SGA in order to render the care needed by a high-risk pregnancy and provide effective antenatal care, thereby ensuring the prevention of unexpected adverse outcomes for both mothers and infants. To date, there is no well accepted method to predict SGA among low-risk pregnant women; therefore, new effective methods must be sought. Currently, the implementation of serum biomarker screening (quad test) for fetal aneuploidy has commenced worldwide, and many studies have shown that additional information derived from such screenings, other than aneuploidy risk estimation, can also be used to i
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