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Obstetric, perinatal, and fetal outcomes in pregnancies with false-positive integrated screening results

机译:妊娠的产科,围产期和胎儿结局以及假阳性综合筛查结果

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OBJECTIVE:: To assess the risk of adverse obstetric, perinatal, and fetal outcomes for pregnant women participating in prenatal sequential integrated screening through the California Prenatal Screening Program who had a false-positive screening result. METHODS:: Women who underwent first-and second-trimester prenatal integrated screening plus nuchal translucency measurement with outcome information available were included. Fetuses and neonates with chromosomal or neural tube defects 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 adverse outcomes in screen-positive compared with screen-negative women. RESULTS:: We identified 9,051 screen-positive and 30,928 screen-negative pregnancies with outcome information available. Compared with screen-negative pregnancies, screen-positive women were more likely to be diagnosed with preeclampsia, placenta previa, or abruption (7.6% screen-positive, 3.8% screen-negative; relative risk 1.7, 95% confidence interval [CI] 1.6-1.8) or experience fetal loss before 20 weeks of gestation (1.9% screen-positive, 0.2% screen-negative; relative risk 3.5, 95% CI 3.2-3.8). Women with positive results for more than one screened condition were at substantially greater risk of fetal and neonatal mortality (relative risks 33.6-156.7, 95% CIs 21.8-194.4). CONCLUSION:: Among pregnancies without chromosomal or neural tube defects, prenatal sequential integrated screening provides information regarding risk across a variety of adverse pregnancy outcomes. LEVEL OF EVIDENCE:: II
机译:目的:评估通过加利福尼亚产前筛查计划参加产前序贯综合筛查的孕妇的产科,围产期和胎儿结局不良的风险,这些筛查结果为假阳性。方法:包括接受孕早期和孕中期产前综合筛查和颈椎半透明测量并提供结果信息的妇女。排除具有染色体或神经管缺陷的胎儿和新生儿。我们将筛查结果为阳性的所有女性与10%筛查结果为阴性的女性随机样本的不良结局风险进行了比较。 Logistic二项式回归用于比较筛查阳性妇女和筛查阴性妇女的不良结局。结果:我们确定了9051例筛查阳性和30928例筛查阴性的孕妇,并提供了结果信息。与筛查阴性孕妇相比,筛查阳性女性更有可能被诊断为先兆子痫,前置胎盘或早产(筛查阳性为7.6%,筛查阴性为3.8%;相对危险度为1.7,95%可信区间[CI] 1.6) -1.8)或在妊娠20周前经历胎儿流失(1.9%筛查阳性,0.2%筛查阴性;相对危险度3.5,95%CI 3.2-3.8)。在一项以上筛查状态中获得阳性结果的妇女,胎儿和新生儿死亡的风险大大增加(相对风险33.6-156.7,95%CI 21.8-194.4)。结论:在没有染色体或神经管缺陷的妊娠中,产前序贯综合筛查可提供有关各种不良妊娠结局风险的信息。证据级别:: II

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