The Correlation Between Abnormal Results Of Down’s Screening In The Second Trimester And Pregnancy Outcome

Background and ObjectiveThe second trimester Down’s screening is mainly used maternal serological indicators such as alpha-fetoprotein(AFP),freeβ-human chorionic gonadotropin(fβ-hCG),free estriol(uE3),combined with maternal age,gestational week,body mass,gravidity and parity,and other related indicators to comprehensively calculate the screening of trisomy 21 syndrome,trisomy 18 syndrome and neural tube defects(NTD).In recent years,many studies have shown that the Down’s screening in the second trimester of pregnancy can not only screen the risk of fetal aneuploidy chromosome and NTD,but also that the risk of Down’s syndrome screening results and serological index anomaly is closely related to the pregnancy outcome,can increase the incidence of adverse pregnancy outcomes,however,the correlation between down’s screening and pregnancy outcomes remains controversial.In this paper,a retrospective study is conducted to analyze the correlation between second trimester Down’s screening for abnormal risk and abnormal serological markers result and adverse pregnancy outcomes,so as to provide a reference for clinical judgment.MethodsThrough the third affiliated hospital of Zhengzhou university information management platform,a total of 13,129 pregnant women who underwent second trimester Down’s screening and have delivery in the Third Affiliated Hospital of Zhengzhou University from January 2018 to January 2019 were randomly selected and collected as study subjects.Retrospective analysis is used for statistical analysis.Group 1:According to the Down’s screening risk results,they are divided into the low risk group(n=11,427),the critical risk group(n=1,115)(including the critical risk of trisomy 21 syndrome(n-1,080),the critical risk of trisomy 18 syndrome(n=35)),and the high risk group(n=587)(including the high risk of trisomy 21 syndrome(n=520),the high risk of trisomy 18 syndrome(n=49),the high risk of NTD(n=18)).Group 2:According to the median multiple value(MoM value)of serological indicators in the Down’s screening results,they are divided into the indicators normal group(n=11,710),the single index abnormal group(n=1,333)(including the AFP decrease group(n=74),the AFP increase group(n=26),fβ-hCG decrease group(n=107),fβ-hCG increase group(n=757),uE3 decrease group(n=369),multiple indicators abnormal group(n=86)(including the AFP decrease and the fβ-hCG increase group(n=44),the fβ-hCG increase and the uE3 decrease group(n=18),the AFP decrease and the uE3 decrease group(n=11),the AFP increase and the fβ-hCG increase group(n=9),the AFP decrease and the fβ-hCG increase and the uE3 decrease group(n=4)).Results1.The incidence of adverse pregnancy outcomes in the abnormal-risk group(16.392%)is higher than that in the low-risk group(14.194%),and the difference is statistically significant(P<0.05);2.The incidence of preterm birth and low birth weight infants in the high-risk NTD group(respectively 22.222%,11.111%)is higher than that in the low-risk group(respectively 1.671%,1.330%),all the differences are statistically significant(P<0.05);3.In the single indicator abnormal group,compared to the index normal group,the risk of hypertensive disorders of pregnancy,preterm birth and low birth weight infants is higher in the pregnant women with elevated AFP(respectively 19.231%,11.538%,7.692%),all the differences are statistically significant(P<0.05);The pregnant women with reduced fβ-hCG have a higher risk of preterm birth and low birth weight infants(respectively 6.542%,4.673%),all the differences are statistically significant(P<0.05);The pregnant women with elevated fβ-hCG have a higher risk of hypertensive disorders of pregnancy(9.115%),and the differences is statistically significant(P<0.05);The pregnant women with reduced uE3 have a higher risk of gestational diabetes mellitus,preterm birth and low birth weight infants(respectively 12.195%,5.962%,2.981%),all the differences are statistically significant(P<0.05);4.Among pregnant women with multiple abnormalities,compared to the index normal group,the pregnant women with reduced AFP and reduced uE3 have a higher risk of low birth weight infants(27.273%),and the differences is statistically significant(P<0.05);The pregnant women with elevated AFP and elevated fβ-hCG have a higher risk of preterm delivery and low birth weight infants(respectively 11.111%,33.333%),all the differences are statistically significant(P<0.05);The pregnant women with reduced AFP and elevated fβ-hCG and reduced uE3 have a higher risk of low birth weight infants(25.000%),and the differences is statistically significant(P<0.05).ConclusionsIn the second trimester,the abnormal risk in the Down’s screening results,especially the high risk of NTD,and the abnormal serological indicators have a certain correlation with the adverse pregnancy outcome,which can be used to predict the occurrence of adverse pregnancy outcomes,and attentions should be paid to prenatal screening and perinatal care.