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Observational Study
. 2020 Oct 15;20(1):621.
doi: 10.1186/s12884-020-03298-9.

Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: a population-based study

Rakchanok Boonpiam  1 , Chanane Wanapirak  1 , Supatra Sirichotiyakul  1 , Ratanaporn Sekararithi  1 , Kuntharee Traisrisilp  2 , Theera Tongsong  1
Affiliations
Observational Study

Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: a population-based study

Rakchanok Boonpiam et al. BMC Pregnancy Childbirth. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: The quad test for aneuploidy screening could also be used as a predictor of SGA, without extra-effort and extra-cost.

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Conflict of interest statement

No

Figures

Fig. 1
Fig. 1
Study flow chart
Fig. 2
Fig. 2
Comparison of AFP MoMs (a), b-hCG MoMs (b), uE3 (c) and hCG (D) between SGA and non-SGA group
Fig. 3
Fig. 3
ROC curves shows performance in predicting small-for-gestational age fetuses of the individual serum biomarker levels and their combination. Area under ROC Curve. MoMs of AFP: 0.724 (95%CI: 0.705–0.743). MoMs of b-hCG: 0.655 (95%CI: 0.634–0.676) MoMs of uE3: 0.597 (95%CI: 0.573–0.621). MoMs of IHA: 0.664 (95%CI: 0.642–0.687). Combined of serum biomarkers (predicted probability): 0.754 (95%CI: 0.732–0.777).
Fig. 4
Fig. 4
Likelihood ratio for small-for-gestational age fetuses, based on MoMs of AFP
See this image and copyright information in PMC

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