Integrated Test for Screening in Down Syndrome as a Predictor of Adverse Pregnancy Outcomes

임신합병증 예측에 있어 다운증후군 통합 선별검사 지표의 의의

  • Park, Sang-Won (Department of Obstetrics and Gynecology, College of Medicine, CHA General Hospital, CHA University) ;
  • Kang, Jin-Hee (Department of Obstetrics and Gynecology, College of Medicine, CHA General Hospital, CHA University) ;
  • Lee, Kyong-Jin (Department of Obstetrics and Gynecology, College of Medicine, CHA General Hospital, CHA University) ;
  • Jun, Hye-Sun (Department of Obstetrics and Gynecology, College of Medicine, CHA General Hospital, CHA University) ;
  • Kang, Myoung-Seo (Department of Clinical Chemistry, CHA General Hospital, CHA University) ;
  • Huh, Ji-Young (Department of Clinical Chemistry, CHA General Hospital, CHA University) ;
  • Cha, Dong-Hyun (Department of Obstetrics and Gynecology, College of Medicine, CHA General Hospital, CHA University)
  • 박상원 (CHA 의과대학교 차병원 산부인과학교실) ;
  • 강진희 (CHA 의과대학교 차병원 산부인과학교실) ;
  • 이경진 (CHA 의과대학교 차병원 산부인과학교실) ;
  • 전혜선 (CHA 의과대학교 차병원 산부인과학교실) ;
  • 강명서 (CHA 의과대학교 차병원 진단검사의학과) ;
  • 허지영 (CHA 의과대학교 차병원 진단검사의학과) ;
  • 차동현 (CHA 의과대학교 차병원 산부인과학교실)
  • Received : 2009.06.05
  • Accepted : 2009.06.22
  • Published : 2009.03.01

Abstract

Purpose: To assess the value of first-trimester pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and second-trimester alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin-A in predicting pregnancy complications other than fetal aneuploidy. Materials and Methods: A retrospective study in 3,121 singleton pregnancies with integrated testing was performed at Kangnam CHA hospital between January 2005 and December 2006. Baseline characteristics, pregnancy outcomes, and serum marker levels were obtained by review of the medical records. We analyzed the data to identify associations between the integrated screening markers and adverse pregnancy outcomes. Statistical analyses were performed with the SPSS program. Results: In preterm labor and preeclampsia, high AFP, hCG, and inhibin-A levels and low PAPP-A and NT levels were found to be significantly correlated (P<0.05). Elevated second-trimester inhibin-A levels were associated with preeclampsia (odds ratio 2.843), low birth weight (odds ratio 1.446), and preterm labor (odds ratio 1.287), and while decreased first-trimester PAPP-A levels were associated with preeclampsia (odds ratio 0.51) and preterm labor (odds ratio 0.75). Conclusion: First- and second-trimester maternal serum markers screening can be used for predicting high-risk pregnancies.