Risk of Severe Maternal Morbidity or Death in Relation to Prenatal Biochemical Screening: Population-Based Cohort Study
| Autor: | Tianhua Huang, Wendy S. Meschino, Eric J.M. Lentz, Joel G. Ray, Alison L. Park, Alec W.R. Langlois |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Population Prenatal diagnosis Chorionic Gonadotropin Risk Assessment Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy Prenatal Diagnosis medicine Humans Pregnancy-Associated Plasma Protein-A Inhibins 030212 general & internal medicine education Ontario education.field_of_study 030219 obstetrics & reproductive medicine Estriol business.industry Obstetrics Multiple of the median Pregnancy Outcome Obstetrics and Gynecology Puerperal Disorders Middle Aged medicine.disease Confidence interval 3. Good health Pregnancy Complications Maternal Mortality Relative risk Pediatrics Perinatology and Child Health Gestation Female alpha-Fetoproteins business Biomarkers Blood Chemical Analysis Maternal Age Cohort study |
| Zdroj: | American Journal of Perinatology. 38:044-059 |
| ISSN: | 1098-8785 0735-1631 |
| Popis: | Objective This study aimed to examine whether prenatal biochemical screening analytes are associated with an increased risk of severe maternal morbidity (SMM) or maternal mortality. Study Design This population-based cohort study includes all women in Ontario, Canada, who underwent prenatal screening from 2001 to 2011. Increasing fifth percentiles of the multiple of the median (MoM) for alphafetoprotein (AFP), total human chorionic gonadotropin, unconjugated estriol (uE3), dimeric inhibin-A (DIA), and pregnancy-associated plasma protein A were evaluated. An abnormally high concentration (>95th percentile MoM) for each analyte, individually and combined, was also evaluated. The main outcome assessed was the adjusted relative risk (aRR) of SMM or maternal mortality from 20 weeks' gestation up to 26 weeks thereafter. Results Among 748,972 pregnancies, 11,177 resulted in SMM or maternal mortality (1.5%). Except for uE3, the aRR of SMM or maternal mortality increased in association with increasing fifth percentiles of the MoM for all analytes. AFP (aRR: 2.10; 95% confidence interval [CI]: 1.97–2.25) and DIA (aRR: 2.33; 95% CI: 1.98–2.74) > 95th versus ≤ 5th percentile of the MoM were especially associated with SMM or death. Conclusion Women with abnormally high concentrations of certain prenatal biochemical analytes may be at a higher risk of SMM or death in pregnancy or postpartum. |
| Databáze: | OpenAIRE |
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