Predicting Adverse Pregnancy Outcomes based on Maternal Serum Markers in Quad Test

OBJECTIVE To compare adverse pregnancy outcomes (APOs) between low-risk and high-risk serum quadruple test for aneuploidy screening. METHODS This cohort design study screened pregnant women who had undergone quad test serum screening in Ratchaburi province, Thailand. The sample of 400 women was divided into two groups, low-risk quad test (n=200) and high-risk quad test (n=200) using random allocation software. Participants were followed up for final outcomes and compared for APOs. The data were analyzed using binary logistic regression analysis and risk ratios. RESULTS Of a total of 1,891 pregnant women, 206 (10.8%) had APOs. Of the women with APOs, 92 (46%) had high-risk quad test results and 32 (16%) were in the low-risk quad test group. The incidence of preeclampsia, intrauterine growth restriction (IUGR) and chromosome abnormality in the high-risk quad test group were all statistically significantly higher in the high-risk quad test group than in the low-risk quad test group (p = 0.013, 0.001, 0.043 respectively). The high-risk quad test group also had a higher incidence of preterm birth, abortion, gestational diabetic mellitus in high-risk quad test group, but the differences were non-statistically significant. CONCLUSIONS High-risk serum quad test results can help predict the risk of APOs such as preeclampsia, IUGR and chromosome abnormality. KEYWORDS quad test, maternal serum marker, adverse pregnancy outcome