Journal of Medical Screening > Volume 16, Number 2 > Pp. 55-59

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Original Articles

The ability of the quadruple test to predict adverse perinatal outcomes in a high-risk obstetric population

Michael R LaoMD, Instructor  , Department of Obstetrics and Gynecology, West Virginia University-Charleston Division, Charleston Area Medical Center, Charleston, West Virginia

Byron C CalhounMD, Professor , Department of Obstetrics and Gynecology, West Virginia University-Charleston Division, Charleston Area Medical Center, Charleston, West Virginia

Luis A BraceroMD, Professor , Department of Obstetrics and Gynecology, West Virginia University-Charleston Division, Charleston Area Medical Center, Charleston, West Virginia

Ying WangPhD, Biostatistician , Center for Health Services & Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, Charleston, West Virginia

Dara J SeyboldM.A.A., Research Associate , Center for Health Services & Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, Charleston, West Virginia

Mike BroceB.A., Research Associate , Center for Health Services & Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, Charleston, West Virginia

Christos G HatjisMD, Professor , Department of Obstetrics and Gynecology, Northeast Ohio Universities College of Medicine, Rootstown, Ohio

Correspondence to: Michael R Lao MD, 800 Pennsylvania Avenue, Suite 304, Charleston, WV 25302, USA; michael.lao{at}camc.org

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Objective To determine the ability of the quadruple Down's syndrome screening test (quad screen) to predict other adverse perinatal outcomes (APO) in a high-risk obstetric population.

Setting A tertiary medical centre in West Virginia.

Methods We retrospectively reviewed 342 obstetric patients with quad screen data from a single clinic. The quad screen included maternal serum levels of alphafetoprotein (AFP), human chorionic gonadotrophin (hCG), uncongjugated oestriol (uE₃), and inhibin A. The risk of APO was compared between patients with at least one abnormal marker versus no abnormal markers and 2 abnormal markers versus <2 abnormal markers. Abnormal markers were determined by cut-off values produced by Receiver Operator Characteristic (ROC) curves and the FASTER trial. Unadjusted and adjusted effects were estimated using logistic regression analysis.

Results The risk of having an APO increased significantly for patients with abnormal markers by about three-fold using ROC and two-fold using FASTER trial thresholds.

Conclusions The quad screen shows value in predicting risk of APO in high-risk patients.

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