Evidence map›Paper›PMID 39242988›Full record

ArticleBMC pregnancy and childbirth2024

Pregnancies with 'double-positive' multiple marker screening results: a population-based study in Ontario, Canada.

Kara Bellai-Dussault, Shelley D Dougan, Deshayne B Fell, Steven Hawken, Tianhua Huang, Carolina Lavin Venegas, Julian Little, Lynn Meng, Nan Okun, Mark Walker and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kara Bellai-DussaultSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada. kbell024@uottawa.ca.
Shelley D DouganPrenatal Screening Ontario, Better Outcomes Registry & Network BORN Ontario, 401 Smyth Road, Ottawa, ON, Canada.
Deshayne B FellSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
Steven HawkenSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
Tianhua HuangPrenatal Screening Ontario, Better Outcomes Registry & Network BORN Ontario, 401 Smyth Road, Ottawa, ON, Canada.
Carolina Lavin VenegasPrenatal Screening Ontario, Better Outcomes Registry & Network BORN Ontario, 401 Smyth Road, Ottawa, ON, Canada.
Julian LittleSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
Lynn MengPrenatal Screening Ontario, Better Outcomes Registry & Network BORN Ontario, 401 Smyth Road, Ottawa, ON, Canada.
Nan OkunPrenatal Screening Ontario, Better Outcomes Registry & Network BORN Ontario, 401 Smyth Road, Ottawa, ON, Canada.
Mark WalkerPrenatal Screening Ontario, Better Outcomes Registry & Network BORN Ontario, 401 Smyth Road, Ottawa, ON, Canada.
Christine M ArmourPrenatal Screening Ontario, Better Outcomes Registry & Network BORN Ontario, 401 Smyth Road, Ottawa, ON, Canada.
Beth K PotterSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.

Funding

CIHR Funding Reference Number FBD-170866
6 · The paper itself

Abstract

backgroundMultiple marker screening is offered to pregnant individuals in many jurisdictions to screen for trisomies 21 and 18. On occasion, the result is 'double-positive'-a screening result that is unexpectedly positive for both aneuploidies. Although this occurs rarely, the paucity of available evidence about the outcomes of these pregnancies hinders patient counselling. This study aimed to investigate the association of double-positive results with preterm birth and other adverse perinatal outcomes.

methodsWe conducted a population-based retrospective cohort study of pregnancies with an estimated date of delivery from September 1, 2016, to March 31, 2021, using province-wide perinatal registry data in Ontario, Canada. Pregnancies with double-positive screening results where trisomies 21 and 18 were ruled-out were compared to pregnancies with screen negative results for both aneuploidies. We used modified Poisson regression models with robust variance estimation to examine the association of double positive results with preterm birth and secondary outcomes.

resultsFrom 429 540 pregnancies with multiple marker screening, 863 (0.2%) had a double-positive result; trisomies 21 and 18 were ruled out in 374 pregnancies, 203 of which resulted in a live birth. Among the pregnancies in the double-positive group resulting in a live birth, the risk of preterm birth was increased compared to pregnancies with a screen negative result: adjusted risk ratio (aRR) 2.6 (95%CI 2.0-3.6), adjusted risk difference (aRD) 10.5% (95%CI 5.4-15.7). In a sensitivity analysis excluding all diagnosed chromosomal abnormalities, the risk of preterm birth remained elevated to a similar degree: aRR 2.6 (95%CI 1.9-3.7), aRD 10.0% (95%CI 4.8-15.3). The risk of other adverse perinatal outcomes was also higher, including the risk of chromosomal abnormalities other than trisomies 21 and 18: aRR 81.1 (95%CI 69.4-94.8), aRD 34.0% (95%CI 29.2-38.8). Pregnancies with double-positive results were also less likely to result in a live birth, even when excluding all diagnosed chromosomal abnormalities; and at increased risk of adverse perinatal outcomes for those resulting in a live birth.

conclusionAlthough rare, double-positive multiple marker screening results are associated with an increased risk of preterm birth and other adverse perinatal outcomes, even when excluding all identified chromosomal abnormalities.

Indexed as

Down SyndromePremature BirthAdultBiomarkersFemaleHumansInfant, NewbornOntarioPregnancyPregnancy OutcomePrenatal DiagnosisRegistriesRetrospective StudiesTrisomy 18 SyndromeBiomarkersChromosomal abnormalitiesDouble-positive resultsMultiple markers screeningPerinatal outcomesPregnancy outcomePrenatal screeningPreterm birthTrisomy 18Trisomy 21

Identifiers

PMID39242988
PMCPMC11380333

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.