Obstetric, perinatal, and fetal outcomes in pregnancies with false-positive integrated screening results.
OBJECTIVE
To assess the risk of adverse obstetric, perinatal, and fetal outcomes for pregnant women participating in prenatal sequential integrated screening through the California Prenatal Screening Program who had a false-positive screening result.


METHODS
Women who underwent first- and second-trimester prenatal integrated screening plus nuchal translucency measurement with outcome information available were included. Fetuses and neonates with chromosomal or neural tube defects were excluded. We compared the risk of adverse outcomes for all women with a positive screening result compared with a 10% random sample of women with a negative screening result. Logistic binomial regression was used to compare adverse outcomes in screen-positive compared with screen-negative women.


RESULTS
We identified 9,051 screen-positive and 30,928 screen-negative pregnancies with outcome information available. Compared with screen-negative pregnancies, screen-positive women were more likely to be diagnosed with preeclampsia, placenta previa, or abruption (7.6% screen-positive, 3.8% screen-negative; relative risk 1.7, 95% confidence interval [CI] 1.6-1.8) or experience fetal loss before 20 weeks of gestation (1.9% screen-positive, 0.2% screen-negative; relative risk 3.5, 95% CI 3.2-3.8). Women with positive results for more than one screened condition were at substantially greater risk of fetal and neonatal mortality (relative risks 33.6-156.7, 95% CIs 21.8-194.4).


CONCLUSIONS
Among pregnancies without chromosomal or neural tube defects, prenatal sequential integrated screening provides information regarding risk across a variety of adverse pregnancy outcomes.
Genetic Disease Screening Program, California Department of Public Health, Richmond, and the Division of Maternal Fetal Medicine, University of California, San Francisco, and the Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California; and the Division of Maternal Fetal Medicine, University of Hawaii, Honolulu, Hawaii.
Rebecca J
RJ
Baer
Robert J
RJ
Currier
Mary E
ME
Norton
Monica C
MC
Flessel
Sara
S
Goldman
Dena
D
Towner
Laura L
LL
Jelliffe-Pawlowski
D000293:Adolescent; D000328:Adult; D002140:California; D002887:Chromosomes, Human, Pair 18; D000013:Congenital Abnormalities / Q000175:diagnosis*; D004314:Down Syndrome / Q000175:diagnosis; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D062145:Maternal Serum Screening Tests; D009436:Neural Tube Defects / Q000175:diagnosis; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D018570:Risk Assessment; D019082:Smith-Lemli-Opitz Syndrome / Q000175:diagnosis; D014314:Trisomy / Q000175:diagnosis; D000073842:Trisomy 18 Syndrome; D055815:Young Adult