Factors of maternal pregnancy that associated with the accuracy of prenatal Down’s syndrome diagnosis by quadruple marker test: a retrospective study

Abstract

Down syndrome screening in pregnant women is necessary for prenatal screening to detect fetal abnormalities during pregnancy. Currently, the blood biochemical level measurement or quadruple marker test stands out as a safe method for the Down’s syndrome screening technique. This research aimed to investigate factors of maternal pregnancy that associated with the accuracy of prenatal Down’s syndrome diagnosis by quadruple marker test. The research design was a retrospective study based on the medical records of 533 pregnant women who were measured prenatal blood biochemical substances at the Obstetrics and Gynecology department, Phetchabun hospital during the period 1 January - 31 December 2021. The research tool was a data recording form consisting of 3 parts of information including 1) general data, 2) pregnancy information, and 3) quadruple marker test results. Statistics used in the data analysis included frequency, percentage, mean, standard deviation, chi-square test, Fisher's exact test, and binary logistic regression. The statistical significance level was set at 0.05.

The results showed that the accuracy of the prenatal diagnosis of Down’s syndrome was achieved by 92.5 percent using the blood biochemical level measurement method. Factors related to the accuracy of prenatal diagnosis of Down’s syndrome by measuring the blood level of biochemical substances that were statistically significant including 3 factors: maternal age greater than or equal to 35 years (adj. OR=0.23, 95%CI=0.11-0.47, p<0.001), 14-16 weeks of gestational age at which blood biochemical levels were measured (adj. OR=8.22, 95%CI=1.36-49.80, p=0.022), and male infants (adj.OR=2.56, 95%CI=1.27-5.19, p=0.009). In conclusion, the gathered information from this study can be used as information for planning Down’s syndrome screening in pregnant women that is accurate and safe including quality planning for further medical interventions.