四联检测预测高危产科人群围产期不良结局的能力。

The ability of the quadruple test to predict adverse perinatal outcomes in a high-risk obstetric population.

作者信息

Lao Michael R, Calhoun Byron C, Bracero Luis A, Wang Ying, Seybold Dara J, Broce Mike, Hatjis Christos G

机构信息

Department of Obstetrics and Gynecology, West Virginia University-Charleston Division, Charleston Area Medical Center, Charleston, West Virginia, USA.

出版信息

J Med Screen. 2009;16(2):55-9. doi: 10.1258/jms.2009.009017.

DOI:10.1258/jms.2009.009017

PMID:19564516

Abstract

OBJECTIVE

To determine the ability of the quadruple Down's syndrome screening test (quad screen) to predict other adverse perinatal outcomes (APO) in a high-risk obstetric population.

SETTING

A tertiary medical centre in West Virginia.

METHODS

We retrospectively reviewed 342 obstetric patients with quad screen data from a single clinic. The quad screen included maternal serum levels of alphafetoprotein (AFP), human chorionic gonadotrophin (hCG), uncongjugated oestriol (uE(3)), and inhibin A. The risk of APO was compared between patients with at least one abnormal marker versus no abnormal markers and >or=2 abnormal markers versus <2 abnormal markers. Abnormal markers were determined by cut-off values produced by Receiver Operator Characteristic (ROC) curves and the FASTER trial. Unadjusted and adjusted effects were estimated using logistic regression analysis.

RESULTS

The risk of having an APO increased significantly for patients with abnormal markers by about three-fold using ROC and two-fold using FASTER trial thresholds.

CONCLUSIONS

The quad screen shows value in predicting risk of APO in high-risk patients.

摘要

目的

确定唐氏综合征四联筛查试验（四联筛查）在高危产科人群中预测其他围产期不良结局（APO）的能力。

地点

西弗吉尼亚州的一家三级医疗中心。

方法

我们回顾性分析了来自单一诊所的342例有四联筛查数据的产科患者。四联筛查包括孕妇血清甲胎蛋白（AFP）、人绒毛膜促性腺激素（hCG）、非结合雌三醇（uE₃）和抑制素A的水平。比较了至少有一个异常标志物的患者与无异常标志物的患者，以及≥2个异常标志物的患者与<2个异常标志物的患者发生APO的风险。异常标志物由受试者操作特征（ROC）曲线和FASTER试验得出的临界值确定。使用逻辑回归分析估计未调整和调整后的效应。