Pregnancy outcomes in unselected singleton pregnant women with an increased risk of first-trimester Down's syndrome.
BACKGROUND
The purpose of this study was to assess outcomes in pregnancies with a positive screen of first-trimester combined test (nuchal translucency, pregnancy-associated plasma protein-A and free beta-human chorionic gonadotropin).


METHODS
Using a cut-off level of 1 in 270, 216 (7.1%) women had a positive screen. Among them, 187 delivered their babies in our hospital and the adverse outcomes, such as spontaneous abortion, intrauterine fetal demize, preterm prelabor rupture of the membranes, preterm labor, intrauterine growth restriction, gestational hypertensive disorders, placenta previa, chromosomal abnormalities and fetal structural anomalies, were identified and compared with the 2097 women who screened negative for Down's syndrome.


RESULTS
Pregnancies with a positive screen had a significantly higher risk of adverse outcomes than those with negative screens (30.5% versus 15.3%; odds ratio 2.4; p < 0.001), especially for those complicated by spontaneous abortion (odds ratio 11.4; p < 0.05) and placenta previa (odds ratio 4.3; p < 0.05).


CONCLUSIONS
Besides fetal chromosomal abnormalities and structural abnormalities, pregnancies with a positive screen for Down's syndrome in the first-trimester had a significantly higher incidence of subsequent adverse obstetric outcomes.
Liu
Silvia So-Aei
SS
Prenatal Diagnosis Center, Cathay General Hospital, Taipei, Taiwan.
Lee
Fa-Kung
FK
Lee
Jia-Ling
JL
Tsai
Ming-Song
MS
Cheong
Mei-Leng
ML
She
Bo-Quing
BQ
Chen
Su-Chee
SC
D000328:Adult; D016022:Case-Control Studies; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D002869:Chromosome Aberrations; D025063:Chromosome Disorders; D004314:Down Syndrome / Q000175:diagnosis* / Q000196:embryology; D005260:Female; D006801:Humans; D007621:Karyotyping; D008423:Maternal Age; D048208:Nuchal Translucency Measurement; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011296:Prenatal Diagnosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal
D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A