Using Down's Syndrome Markers to Predict Pre-eclampsia and Small for Gestational Age
Author Information
Author(s): Morris Rachel K, Cnossen Jeltsje S, Langejans Marloes, Robson Stephen C, Kleijnen Jos, ter Riet Gerben, Mol Ben W, van der Post Joris AM, Khan Khalid S
Primary Institution: Academic Department of Obstetrics and Gynaecology, University of Birmingham
Hypothesis
Can serum analytes used in Down's syndrome screening accurately predict pre-eclampsia and small for gestational age?
Conclusion
Down's serum screening analytes have low predictive accuracy for pre-eclampsia and small for gestational age.
Supporting Evidence
- Five serum screening markers were evaluated across 44 studies for pre-eclampsia and 86 studies for small for gestational age.
- The best predictor for pre-eclampsia was inhibin A>2.79MoM.
- For small for gestational age, the best predictor was AFP>2.0MoM.
- Overall, the predictive accuracy of the serum markers was low.
Takeaway
Doctors used blood tests to try to predict if pregnant women would have problems like pre-eclampsia or having small babies, but the tests didn't work very well.
Methodology
The study systematically reviewed and meta-analyzed data from various databases and included studies that reported on serum analytes used in Down's syndrome screening before the 25th week of gestation.
Potential Biases
There was poor reporting of patient selection criteria and blinding of the reference test.
Limitations
The included studies were heterogeneous, and there were methodological and reporting limitations.
Participant Demographics
The study included 551,642 pregnant women, with 4,376 cases of pre-eclampsia and 20,339 cases of small for gestational age.
Statistical Information
Confidence Interval
95% CI ranges provided for various likelihood ratios.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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