Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
BMC Pregnancy Childbirth. 2020 Oct 15;20(1):621. doi: 10.1186/s12884-020-03298-9.
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.
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.
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.
The quad test for aneuploidy screening could also be used as a predictor of SGA, without extra-effort and extra-cost.
为了确定四联试验（甲胎蛋白：AFP；游离β-人绒毛膜促性腺激素：b-hCG；非结合雌三醇：uE3 和抑制素-A：IHA）与胎儿生长受限的关系，并构建预测胎儿生长受限（SGA）的模型。
对接受四联试验进行染色体非整倍体筛查的女性进行随访，以获得最终结局。比较 SGA 组和正常胎儿的四项生化标志物中位数倍数（MoM）。使用二项逻辑回归分析构建个体生物标志物及其组合预测 SGA 的模型，并确定其预测 SGA 的诊断性能。
在 10155 名符合条件的孕妇中，578 名（5.7%）和 9577 名（94.3%）胎儿为 SGA 和正常生长。高水平的 AFP、b-hCG 和 IHA 以及低水平的 uE3 显著增加了 SGA 的风险。构建的预测方程对 SGA 具有预测性能，AFP、b-hCG、uE3、IHA 和组合的受试者工作特征曲线下面积分别为 0.724、0.655、0.597、0.664 和 0.754。
四联试验筛查也可作为 SGA 的预测指标，无需额外的努力和额外的费用。
