Document Detail


Use of the combined first-trimester screen result and low PAPP-A to predict risk of adverse fetal outcomes.
MedLine Citation:
PMID:  18186146     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To investigate associations between combined first-trimester screen result, pregnancy associated plasma protein-A (PAPP-A) level and adverse fetal outcomes in women. METHODS: Pregnancy 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 > or = 1 in 300 defined screen positive women. RESULTS: Screen 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 (< or =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. CONCLUSIONS: Women 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.
Authors:
Sandie L Barrett; Carol Bower; Narelle C Hadlow
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  28     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-16     Completed Date:  2008-05-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  28-35     Citation Subset:  IM    
Affiliation:
Western Diagnostic Pathology, Symbion Health, Western Australia, Australia. sandieb@aapt.net.au
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / epidemiology
Adult
Chorionic Gonadotropin, beta Subunit, Human / blood
Chromosome Aberrations
Congenital Abnormalities / diagnosis
Down Syndrome / diagnosis
Female
Fetal Death / epidemiology
Gestational Age
Humans
Pregnancy
Pregnancy Outcome*
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / analysis*
Prenatal Diagnosis / methods*
Ultrasonography, Prenatal
Western Australia / epidemiology
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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