SynthesisBMC pregnancy and childbirth2008
Serum screening with Down's syndrome markers to predict pre-eclampsia and small for gestational age: systematic review and meta-analysis.
Synthesis in BMC pregnancy and childbirth, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Towards the Development of a Conceptual Framework of the Determinants of Pre-Eclampsia: A Hierarchical Systematic Review of Biomarkers.BJOG : an international journal of obstetrics and gynaecology · 2026Pooled it
- Development and validation of prediction models for fetal growth restriction and birthweight: an individual participant data meta-analysis.Health technology assessment (Winchester, England) · 2024Pooled it
- False-Positive Maternal Serum Screens in the Second Trimester as Markers of Placentally Mediated Complications Later in Pregnancy: A Systematic Review and Meta-Analysis.Disease markers · 2021Pooled it
- Differentially expressed genes in the pre-eclamptic placenta: a systematic review and meta-analysis.PloS one · 2013Pooled it
- Methodological quality of test accuracy studies included in systematic reviews in obstetrics and gynaecology: sources of bias.BMC women's health · 2011Pooled it
- Quantification of maternal serum cell-free fetal DNA in early-onset preeclampsia.International journal of molecular sciences · 2013Trial
- The association of first and second-trimester serum biomarkers with adverse perinatal outcomes in late-preterm and term deliveries: a retrospective cohort study.BMC pregnancy and childbirth · 2026Article
- Exploring free pregnancy associated plasma protein a (fPAPP-A) as a biomarker in early pregnancy.Practical laboratory medicine · 2024Article
- Circulating biomarkers associated with placental dysfunction and their utility for predicting fetal growth restriction.Clinical science (London, England : 1979) · 2023Article
- Combined maternal risk factors and the Quadruple test to predict late-onset preeclampsia in pregnant Thai women.BMC pregnancy and childbirth · 2023Article
- Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study.Scientific reports · 2020Article
- Validation and development of models using clinical, biochemical and ultrasound markers for predicting pre-eclampsia: an individual participant data meta-analysis.Health technology assessment (Winchester, England) · 2020Article
- The Knowledge, Attitude, Practices, and Satisfaction of Non-Invasive Prenatal Testing among Chinese Pregnant Women under Different Payment Schemes: A Comparative Study.International journal of environmental research and public health · 2020Article
- The effect of maternal alcohol and drug abuse on first trimester screening analytes: a retrospective cohort study.BMC pregnancy and childbirth · 2020Article
- Tracking placental development in health and disease.Nature reviews. Endocrinology · 2020Review
- Prenatal Biochemical Screening and a Woman's Long-Term Risk of Cancer: A Population-Based Cohort Study.JNCI cancer spectrum · 2020Article
- Knowledge Gaps and Emerging Research Areas in Intrauterine Growth Restriction-Associated Brain Injury.Frontiers in endocrinology · 2019Review
- Prenatal biochemical screening and long term risk of maternal cardiovascular disease: population based cohort study.BMJ (Clinical research ed.) · 2018Article
- External validation, update and development of prediction models for pre-eclampsia using an Individual Participant Data (IPD) meta-analysis: the International Prediction of Pregnancy Complication Network (IPPIC pre-eclampsia) protocol.Diagnostic and prognostic research · 2017Article
- Maternal Serum Aneuploidy Screen and Adverse Pregnancy Outcomes.Journal of obstetrics and gynaecology of India · 2016Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundReliable antenatal identification of pre-eclampsia and small for gestational age is crucial to judicious allocation of monitoring resources and use of preventative treatment with the prospect of improving maternal/perinatal outcome. The purpose of this systematic review was to determine the accuracy of five serum analytes used in Down's serum screening for prediction of pre-eclampsia and/or small for gestational age.
methodsThe data sources included Medline, Embase, Cochrane library, Medion (inception to February 2007), hand searching of relevant journals, reference list checking of included articles, contact with experts. Two reviewers independently selected the articles in which the accuracy of an analyte used in Downs's serum screening before the 25th gestational week was associated with the occurrence of pre-eclampsia and/or small for gestational age without language restrictions. Two authors independently extracted data on study characteristics, quality and results.
resultsFive serum screening markers were evaluated. 44 studies, testing 169,637 pregnant women (4376 pre-eclampsia cases) and 86 studies, testing 382,005 women (20,339 fetal growth restriction cases) met the selection criteria. The results showed low predictive accuracy overall. For pre-eclampsia the best predictor was inhibin A>2.79MoM positive likelihood ratio 19.52 (8.33,45.79) and negative likelihood ratio 0.30 (0.13,0.68) (single study). For small for gestational age it was AFP>2.0MoM to predict birth weight < 10th centile with birth < 37 weeks positive likelihood ratio 27.96 (8.02,97.48) and negative likelihood ratio 0.78 (0.55,1.11) (single study). A potential clinical application using aspirin as a treatment is given as an example.There were methodological and reporting limitations in the included studies thus studies were heterogeneous giving pooled results with wide confidence intervals.
conclusionDown's serum screening analytes have low predictive accuracy for pre-eclampsia and small for gestational age. They may be a useful means of risk assessment or of use in prediction when combined with other tests.
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