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

`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 (uE(3)) 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.