title: Introduction of a nomogram for predicting adverse pregnancy outcomes based on maternal serum markers in the quad screen test.
abstract: OBJECTIVE
  The aim of this study was to develop a nomogram that can calculate a total score, derived from each serum marker in the quad screen test, for systematically predicting adverse pregnancy outcomes (APOs).
  
  
  METHODS
  We retrospectively reviewed 3684 singleton pregnant women who underwent a quad screen test and gave birth at a single medical centre from January 2005 to December 2010. The serum marker data from the quad screen test and pregnancy outcomes were used to construct logistic regression models for predicting the risks of APOs. APO was defined as the presence of at least one of the following: preeclampsia, preterm delivery before 34 weeks of gestation, small for gestational age, foetal loss, and foetal demise. A graphic nomogram was generated to represent the scoring model using the regression coefficient of each serum marker.
  
  
  RESULTS
  A nomogram for the prediction of APOs using each serum marker in the quad test was developed based on the logistic regression analysis. The positive predictive values for the subsequent development of an APO were ascended stepwise as the calculated score increases. The area under the receiver operating characteristic curve of this score for the prediction of APO was 0.596 (95 % confidence interval 0.569-0.623).
  
  
  CONCLUSIONS
  We here introduced a nomogram for stratifying the risk of APOs in patients with abnormal serum markers in the quad screen test. Although the validity of the nomogram is too weak to be used in clinical routine, but it may provide additional information for practitioners counselling pregnant women and for predicting APOs.
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Jung-Joo
authors.initials: JJ
authors.lastname: An
authors.forename: Hyun-Young
authors.initials: HY
authors.lastname: Ji
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: You
authors.forename: Sook-Young
authors.initials: SY
authors.lastname: Woo
authors.forename: Suk-Joo
authors.initials: SJ
authors.lastname: Choi
authors.forename: Soo-Young
authors.initials: SY
authors.lastname: Oh
authors.forename: Cheong-Rae
authors.initials: CR
authors.lastname: Roh
authors.forename: Jong-Hwa
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D006063:Chorionic Gonadotropin / Q000097:blood*; D000069545:Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D004964:Estriol / Q000097:blood; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007265:Inhibins / Q000097:blood; D016015:Logistic Models; D008875:Middle Aged; D049451:Nomograms; D007752:Obstetric Labor, Premature / Q000175:diagnosis; D017063:Outcome Assessment, Health Care; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012372:ROC Curve; D012189:Retrospective Studies; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; D000069545:Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D000509:alpha-Fetoproteins; D007265:Inhibins; D004964:Estriol