Adverse pregnancy outcomes in pregnant women with integrated screening for positive aneuploidy at Babol University of Medical Sciences: April 2017 to June 2019

Document Type : Original Article

Authors

1 General Medicine Student, Student Research Committee, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.

2 Associated Professor, Department of Midwifery, Reproductive Health and Infertility Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

3 Assistant Professor, Department of Obstetrics and Gynecology, Research Development Unit, Ayatollah Rouhani Hospital, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.

4 Assistant Professor, Department of Epidemiology, Social Determinants of Health Research Center , Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Abstract

Introduction: Aneuploidy screening before birth is essential prenatal care for all pregnant women, regardless of maternal age. Prenatal screening allows prenatal treatment of the fetus and proper pregnancy management. This study was performed with aim to determine the adverse pregnancy in pregnant women with positive aneuploidy screening at first and second trimester or combination of them.
Methods: This cohort study was performed on 423 pregnant women from April 2017 to June 2019. Demographic, fertility, and laboratory data were recorded from the prenatal file or maternal self-report during prenatal care receiving, and then, the pregnant women were placed in two groups of women with positive and negative serum aneuploidy screening in terms of adverse pregnancy outcomes. Data were analyzed by SPSS software (version 23), and Chi-square, T-test and crude and adjusted logistic regression. P < 0.05 was considered statistically significant.
Results: In this study, 423 pregnant women in terms of adverse pregnancy outcomes were placed in two groups of pregnant women with positive and negative serum aneuploidy screening. Mean age in the positive and negative serum aneuploidy screening groups were 33.08 ± 5.77 and 29.54 ± 5.85, respectively (P = 0.001). The incidence of abortion, preeclampsia, intrauterine growth restriction and NICU admission was higher in screen-positive group compared to screen-negative group. The crude odds risk ratio of adverse pregnancy outcomes in screen-positive women (OR = 1.87 (1/15- 3/03) P = 0.04 and adjusted risk odds after controlling for maternal age, body mass index and parity was OR = 1.79 (1.09 -2.96) P = 0.02.
Conclusion: Adverse pregnancy outcomes are higher in women with positive aneuploidy screening. Further studies are needed to determine the sensitivity and specificity and accuracy of positive aneuploidy screening.

Keywords

References

  1. Bringman JJ. Invasive prenatal genetic testing: A Catholic healthcare provider's perspective. Linacre Q 2014; 81(4):302-313.
  2. Milunsky A, Milunsky JM. Genetic disorders and the fetus: diagnosis, prevention, and treatment: John Wiley & Sons; 2015.
  3. Driscoll DA, Gross S. Prenatal screening for aneuploidy. New England Journal of Medicine 2009; 360(24):2556-62.
  4. Driscoll DA, Morgan MA, Schulkin J. Screening for Down syndrome: changing practice of obstetricians. Am J Obstet Gynecol 2009; 200(4):459.e1-459.e4599.
  5. Group TNPSW, Gregg AR, Gross S, Best R, Monaghan K, Bajaj K, et al. ACMG statement on noninvasive prenatal screening for fetal aneuploidy. Genetics in Medicine 2013; 15(5):395.
  6. Allen EG, Freeman SB, Druschel C, Hobbs CA, O'Leary LA, Romitti PA, et al. Maternal age and risk for trisomy 21 assessed by the origin of chromosome nondisjunction: a report from the Atlanta and National Down Syndrome Projects. Hum Genet 2009; 125(1):41-52.
  7. Bouman K, Bakker MK, Birnie E, Ter Beek L, Bilardo CM, van Langen IM, et al. The impact of national prenatal screening on the time of diagnosis and outcome of pregnancies affected with common trisomies, a cohort study in the Northern Netherlands. BMC pregnancy and childbirth 2017; 17(1):4.
  8. de Walle, H. E.Moghaddasi MS. Sunflower tissue culture. Advances in Environmental Biology 2011: 746-56.
  9. Ahmed S, Bryant LD, Cole P. Midwives' perceptions of their role as facilitators of informed choice in antenatal screening. Midwifery 2013; 29(7):745-750.
  10. Ternby E, Ingvoldstad C, Annerén G, Axelsson O. Midwives and information on prenatal testing with focus on Down syndrome. Prenat Diagn 2015; 35(12):1202-1207.
  11. Driggers RW, Seibert DC. Prenatal screening: new guidelines, new challenges. The Journal for Nurse Practitioners 2008; 4(5):351-6.
  12. Vellamkondu A, Vasudeva A, Bhat RG, Kamath A, Amin SV, Rai L, et al. Risk Assessment at 11-14-Week Antenatal Visit: A Tertiary Referral Center Experience from South India. J Obstet Gynaecol India 2017; 67(6):421-427.
  13. Anderson U, Olsson M, Kristensen K, Åkerström B, Hansson S. Biochemical markers to predict preeclampsia. Placenta 2012; 33:S42-S7.
  14. Pergament E, Stein A, Fiddler M, Cho N, Kupferminc M. Adverse pregnancy outcome after a false-positive screen for Down syndrome using multiple markers. Obstetrics & Gynecology 1995; 86(2):255-8.
  15. Munim S, Ismail H. Pregnancy loss rate following amniocentesis. Journal of the Pakistan Medical Association 2012; 62(6):545.
  16. Green-top Guideline No.8, Amniocentesis and chorionic villus sampling, Royal College of Obstetricians and Gynaecologists, London. June 2010. https://cdn1.sph.harvard.edu/wp-content/uploads/sites/2413/2014/08/Amniocentesis_RoyalCollege_ResArt_2010.pdf
  17. Dugoff L; Society for Maternal-Fetal Medicine. First- and second-trimester maternal serum markers for aneuploidy and adverse obstetric outcomes. Obstet Gynecol 2010; 115(5):1052-1061.
  18. Feyzbakhsh S, Mozaffari R, Tajik A, Zafarnia M, Fardmanesh A. Triple test and pregnancy outcome association. Academic Research International 2013; 4(1):368.
  19. Zhong Y, Zhu F, Ding Y. Serum screening in first trimester to predict pre-eclampsia, small for gestational age and preterm delivery: systematic review and meta-analysis. BMC Pregnancy Childbirth 2015; 15:191.
  20. Sonek J, Krantz D, Carmichael J, Downing C, Jessup K, Haidar Z, et al. First-trimester screening for early and late preeclampsia using maternal characteristics, biomarkers, and estimated placental volume. Am J Obstet Gynecol 2018; 218(1):126.e1-126.e13.
  21. Hasanzadeh R, Naghizadeh S, Azari S, Ebrahimpour Mirza Rezaei M. Diagnosis of Aneuploidies by amniocentesis in high risk cases of first trimester screening test. Iran J Obstet Gynecol Infertil 2014; 17(119):18-26.
  22. Ree PH, Hahn WB, Chang SW, Jung SH, Kang JH, Cha DH, et al. Early detection of preeclampsia using inhibin a and other second-trimester serum markers. Fetal Diagn Ther 2011; 29(4):280-6.
  23. Yu N, Cui H, Chen X, Chang Y. First trimester maternal serum analytes and second trimester uterine artery Doppler in the prediction of preeclampsia and fetal growth restriction. Taiwan J Obstet Gynecol 2017; 56(3):358-361.
  24. Bahrami Taghanaki HR, Hashemian M, Lotfalizadeh M, Noras MR. The relationship between Body Mass Index (BMI) and birth weight and some pregnancy outcomes. Iran J Obstet Gynecol Infertil 2016; 19(30):1-8.
  25. Hook EB. Rates of chromosome abnormalities at different maternal ages. Obstet Gynecol 1981; 58(3):282-285.
  26. Hook EB, Cross PK, Schreinemachers DM. Chromosomal abnormality rates at amniocentesis and in live-born infants. JAMA 1983; 249(15):2034-2038.
  27. Hu X, Roberts JR, Apopa PL, Kan YW, Ma Q. Accelerated ovarian failure induced by 4-vinyl cyclohexene diepoxide in Nrf2 null mice. Mol Cell Biol 2006; 26(3):940-954.
  28. Warburton D. The effect of maternal age on the frequency of trisomy: change in meiosis or in utero selection?. Prog Clin Biol Res 1989; 311:165-181.
  29. Freeman SB, Yang Q, Allran K, Taft LF, Sherman SL. Women with a reduced ovarian complement may have an increased risk for a child with Down syndrome. Am J Hum Genet 2000; 66(5):1680-1683.
  30. Kline J, Kinney A, Levin B, Warburton D. Trisomic pregnancy and earlier age at menopause. Am J Hum Genet 2000; 67(2):395-404.
  31. Keefe DL, Franco S, Liu L, Trimarchi J, Cao B, Weitzen S, et al. Telomere length predicts embryo fragmentation after in vitro fertilization in women--toward a telomere theory of reproductive aging in women. Am J Obstet Gynecol 2005; 192(4):1256-60; discussion 1260-1.
  32. Liu L, Franco S, Spyropoulos B, Moens PB, Blasco MA, Keefe DL. Irregular telomeres impair meiotic synapsis and recombination in mice. Proceedings of the National Academy of Sciences 2004; 101(17):6496-501.

The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 23, Issue 7
September 2020
Pages 29-38

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