Abstract

OBSTETRIC AND PERINATAL OUTCOMES IN PREGNANCIES WITH POSITIVE FIRST TRIMESTER SCREENING AND NORMAL KARYOTYPE

Nahid Shahbazian, Mojgan Barati, Soodabeh Rahimi-Saghand*, Razieh Mohamad Jafari, Sara Masihi, Najmieh Saadati, Mahin Najafian

Abstract

Objective: To assess the risk of adverse obstetric and perinatal outcomes for pregnant women participating in prenatal first trimester screening of down syndrome who had a positive screening result and normal karyotype. Methods: This study was performed in the Fetal Medicine Unit of Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences from 2013-2015.Women who underwent first trimester prenatal screening with outcome information available were included in this study. Fetuses with chromosomal abnormality were excluded. We compared the risk of adverse outcomes for all women with a positive screening result compared with a 10% random sample of women with a negative screening result. Logistic binomial regression was used to compare outcomes in screenpositive compared with screen-negative women. Results: We identified 138 screen-positive and 215 screen-negative pregnancies with outcome information available. Adverse outcomes significantly increased in screen positive women included spantaneus abortion and Preterm birth. spantaneus abortion 6 (4.3%)screen-positive, 1 (.5%) screen-negative; Odds ratio .011 [CI] (1.155_81.456 ) ,preterm labor 18 (12.9%) screen-positive, 9 (4.2%) screennegative; Odds ratio .002 confidence interval [CI] 1.49_7.85. Preeclampsia and still birth were higher but not significantly increased in screen positive pregnancies. Pregnancies with low PAPP-A (≤0.4) multiples of the median (MoM)) had higher risk of preterm labor (p value=.00) and preeclampsia (p value=.00) compared to those with PAPP-A >0.4 MoM. Conclusion: Among pregnancies with positive first trimester prenatal screening of down syndrome and normal karyotype provides information regarding risk across a variety of adverse pregnancy outcomes.

Keywords: First-trimester screening; adverse pregnancy outcomes; PAPP-A.