The Relationship Between 121404 Second‐trimester Maternal Serum Screening And Adverse Pregnancy Outcomes In Ningbo

Objective The purpose of this study was to investigate the correlation between abnormal multiples of median(Mo M) of second-trimester maternal serum triple screening(STMSTS) markers and adverse pregnancy outcomes(APO).Methods 1. 121404 singleton pregnant women who underwent STMSTS, <35 years old and had a complete follow-up date in 2012 and 2013 in Ningbo were recruited. 2. Alpha-fetoprotein(AFP), free β-subunit human chorionic gonadotropin(fβ-h CG) and unconjugated estriol(u E3) levels were converted to Mo M by normal median of maternal age, gestational age, body mass in Ningbo region. We calculated and grouped as 0.7≤AFP Mo M≤2.0、0.5≤fβ-h CG Mo M≤2.0、u E3 Mo M≥0.5 was normal, beyond which was consider as abnormal(elevated or reduced). 3. The Mo M of STMSTS makers between women with APO and normal outcomes were compared. 4. Chi-square test or Fisher’s exact test were used for statistical comparison. When P<0.05, it was statistically significant.Results 1. Among the 121404 pregnant women, there were 1559 cases of APO(group 1), the positive rate of which was 12.84‰(1559/121404). In this study 119845 pregnant women were normal outcomes(group 2), which were healthy during pregnancy examinations, so were their fetuses(postnatal 42 days). 2. There was statistically significant differences in Mo M of triple screening markers between two groups(P<0.05). 3. In group 1 the incidence of abnormal Mo M of AFP, fβ-h CG, u E3(AFP>2.0Mo M, fβ-h CG >2.0 Mo M, u E3 <0.5 Mo M, AFP<0.7 Mo M and fβ-h CG <0.5 Mo M) was 8.85%(138/1559), 20.27%(317/1559), 5.97%(93/1559), 10.78%(168/1559) and 11.16%(174/1559) respectively; the incidence of abnormal Mo M of one, two or three markers was 33.48%(522/1559), 8.79%(137/1559), 1.99%(31/1559). However, In group 2, the incidence of abnormal Mo M of AFP, fβ-h CG, u E3 was 1.91%(2287/119845), 13.42%(16083/119845), 0.90%(1076/119845), 10.72%(12843/119845) and 10.59%(12689/119845); the incidence of abnormal Mo M of one, two or three markers was 30.41%(36439/119845), 3.46%(4142/119845), 0.07%(85/119845). There was a significant difference of abnormal Mo M of triple screening makers between the two groups(P<0.05), except the groups of AFP<0.7 Mo M and fβ-h CG <0.5 Mo M. 4. Compared the pregnancy outcomes with each maker of Mo M abnormal and normal: elevated Mo M of AFP: OR=5.04, 95%CI: 4.21~6.04, P<0.01; elevated Mo M of fβ-h CG: OR=1.67, 95%CI: 1.48~1.90,P<0.01; reduced Mo M of u E3: OR=7.00, 95%CI: 5.63~8.71, P<0.01; only one abnormal Mo M of markers: OR=1.31, 95%CI:1.17~1.46,P<0.01; two abnormal Mo M of markers: OR=3.01, 95%CI: 2.51~3.62,P<0.01; three abnormal Mo M of markers: OR=33.23, 95%CI: 21.91~50.41, P<0.01).Conclusions The risk of APO in elevated Mo M of AFP and fβ-h CG, reduced Mo M of u E3, abnormal Mo M of only one, two and three markers is increased. When the Mo M of three markers all abnormal, the risk of APO is highest. Women with abnormal levels of serum markers, we shouldn’t only pay attention to target disease diagnosis, but also should give great importance to the assessment and monitoring of APO.