False-Positive Maternal Serum Screens in the Second Trimester as Markers of Placentally Mediated Complications Later in Pregnancy: A Systematic Review and Meta-Analysis
Table 2
Summary of findings and quality of evidence (GRADE), overall and by a triple-marker maternal serum screening test.
Outcomes
Estimated risk (baseline risk in population)a
Total number of participants (# of studies)
Pooled OR (95% CI)
Number of participants in TMS studies (# of studies)
Pooled OR, by TMS (95% CI)
Quality of evidence (GRADE)b
Comments
Preeclampsia (PET)
2.6-3.5%
(6 studies)
1.28 (1.09-1.51)
(4 studies)
1.28 (1.09-1.51)
Moderate
Consistency of findings; low heterogeneity (low-mod for TMS); low-risk publication bias
Stillbirth (IUFD)
0.5-0.6% (high-income countries) vs. 1.5-3.5% (low-income countries)
(8 studies)
1.95 (0.96-3.96)
(5 studies)
2.46 (1.94-3.12)
Moderate
Stronger relationship and narrower CIs for TMS tests vs. pooled overall; low heterogeneity; low-risk publication bias
Fetal growth restriction (FGR)
3-10%c
(8 studies)
1.65 (0.97-2.82)
(4 studies)
1.63 (0.79-3.38)
Low
Significant publication bias; inconsistency of results
Preterm birth (PTB)
8-10%
(7 studies)
1.16 (0.78-1.72)
(3 studies)
1.24 (0.73-2.11)
Low
Significant heterogeneity & inconsistency of results between studies
Legend: TMS = triple-marker maternal serum screening tests; OR = odds ratio; CI = confidence interval. aSee References [36–38, 56–62]. bSee Reference [42]. cFetal growth restriction using <10th percentile as a cut-off correlates with baseline population risk ~10%. However, within the literature, there is a range of reported risks (between 3 and 10%) based on the different growth percentile cut-offs used.
