Prenatal Triple Marker Screening and Pregnancy Outcomes

Park, Min Jeong; Song, Wonkeun

Abstract

BACKGROUND: Maternal serum triple marker test during 15-20 weeks is a useful prenatal screening technique for detecting chromosomal abnormalities and neural tube defect (NTD). The aim of this study was to investigate the pregnancy outcomes of the women with positive screens in a retrospective case-controlled study.
METHODS
Total 2765 women in second trimester received prenatal triple marker screening at Kangnam Sacred Heart Hospital between March, 1998 and February, 2002. The study group included 98 women with screen positive results and known pregnancy outcomes and the 194 age-matched contols with negative screen results. We reviewed the triple marker results and pregnancy outcomes in both groups.
RESULTS
The overall positive rate of triple marker test was 4.3%, composed of 2.9% for Down syndrome and 1.4% for neural tube defect. Among 98 screen positive women, only one case of trisomy 21 was detected. The adverse outcomes occurred in 23 of 97 pregnancies (23.7%) in the false-positive group and in 14 of 194 matched control pregnancies (9.8%)(P<0.05). Women with false-positive screens were significantly higher than their matched controls in the incidence of premature rupture of membrane, pregnancy-induced hypertension/preeclmapsia, small for gestational age and fetal/neonatal death (P<0.05).
CONCLUSION
Women with false-positive screens of triple markers are at increased risk for various adverse pregnancy outcomes. Careful fetal examination and thoughtful strategy for perinatal management are warranted for these patients.