Quad test for fetal aneuploidy screening as a predictor of fetal growth restriction: A population-based study

Abstract

Background: To identify the relationship between quadruple test for aneuploidy screening (alpha-fetoprotein: AFP; free beta-human chorionic gonadotropin: b-hCG; unconjugated estriol: uE3 and inhibin-A: IHA) and fetal growth restriction and to construct predictive models for fetal growth restriction (FGR).Methods: Women who underwent quadruple test for aneuploidy were followed-up for final outcomes. The multiple of median (MoMs) of the four biochemical markers for the FGR group and those of normal fetuses were compared. The models for predicting FGR by the individual biomarkers and their combination were constructed using binary logistic regression analysis, and their diagnostic performances in predicting FGR were determined.Results: Of 10,155 eligible pregnant women, 578 (5.7%) and 9577 (94.3%) had FGR and normal growth, respectively. High levels of AFP, b-hCG and IHA but low levels of uE3 significantly increased the risk of FGR. The constructed predictive equations had predictive performance for FGR, with areas under the receiver-operated characteristic curve of 0.724, 0.655, 0.597, 0.664 and 0.754 for AFP, b-hCG, uE3, IHA, and the combination, respectively.Conclusion: The quad test for aneuploidy screening could also be used as a predictor of FGR, without extra-effort and extra-cost.