ARE FALSE-POSITIVE MATERNAL SERUM SCREENS FOR FETAL ANEUPLOIDY ASSOCIATED WITH ADVERSE OUTCOMES AMONGST SINGLETON PREGNANCIES GLOBALLY? A SYSTEMATIC REVIEW AND META-ANALYSIS.

Objectives To investigate the association between false-positive, maternal serum screening (MSS) tests and the risk of adverse outcomes amongst singleton pregnancies. Methods A systematic review of the literature was conducted using electronic search engines (PubMed, Medline, Embase, CINAHL, Web of Science and Scopus), as well as hand-searches of scientific meeting abstracts and other grey literature sources (ProQuest Dissertations and Google Scholar) to August 2018. Observational studies comparing the risk of adverse pregnancy outcomes amongst singleton pregnancies with false-positive MSS tests to those of screen-negative singleton controls were assessed for inclusion. Outcomes of interest included preeclampsia, fetal growth restriction, preterm birth and stillbirth. A random-effects meta-analysis was then performed. Odds ratios and 95% confidence intervals were pooled by outcome to generate the summary effect estimates. Results 16 studies enrolling 68515 singleton pregnancies met inclusion criteria and were included in this review. After excluding studies of poor quality, a formal meta-analysis was performed utilizing 10 studies. There was evidence of an increased odds of preeclampsia (OR 1.28, 95% CI 1.09 to 1.51) and stillbirth (OR 2.46, 95% CI 1.94 to 3.12) amongst pregnancies with a false-positive MSS when compared to controls. There was no statistically significant association between false-positive MSS and either fetal growth restriction or preterm birth. Conclusions There is some evidence of an association between a false-positive MSS and an increased risk of stillbirth and preeclampsia. Future large-scale, prospective studies should be conducted to better determine the predictive value of false-positive MSS for adverse pregnancy outcomes and potential interventions to mitigate these risks.