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Background: Maternal serum sample screening in the first and second trimesters has been commonly used to identify women who are at risk of fetal trisomy 21. In addition, these serum markers are associated with adverse perinatal outcomes. Hence, the present study was conducted to determine the relationship between false positive screening results of Down syndrome and adverse pregnancy outcomes. Material and Methods: This prospective, two-group, cohort study was conducted on 608 pregnant women who had undergone fetal contingent screening. They were selected through convenience sampling in the twentieth week of pregnancy and were followed up until delivery. The raw Odd Ratios (OR), Relative Risk (RR), and adjusted OR of adverse pregnancy outcomes were calculated in the false positive and true negative groups. Results: The adjusted OR of developing preeclampsia was 1.98 (95% CI: 1.14-3.42), and its RR was 2.13 (95% CI: 1.34-3.38) times higher in the false positive group. Moreover, the adjusted OR of Small for Gestational Age (SGA) was 2.80 (95% CI: 1.76-4.47), and its RR was 2.28 (95% CI: 1.54-3.36) times higher in the false positive group. The adjusted OR of Low Birth Weight (LBW) was 3.34 (95% CI: 1.97-5.64), and its RR was 2.65 (95% CI: 1.72-4.11) times higher in the false positive group. In addition, no significant difference was observed between false positive and true negative groups in terms of preterm birth. Conclusions: Women with a false positive fetal screening test result are more likely to suffer from preeclampsia, SGA, and LBW and require planned prenatal care. [ABSTRACT FROM AUTHOR]

Background: Prenatal diagnosis of fetal anomalies leads to parental psychological stress and decision-making challenges to continue or terminate pregnancy. Continuing pregnancy despite fetal anomaly can cause confusion, anxiety and depression in parents, so it seems necessary to be aware of their needs and appropriately respond to them. This study was conducted to exploring experiences about Continuation Pregnancy despite fetal anomaly in the socio-cultural context of Iran. Methods: Qualitative exploratory descriptive study, 35 participants including 15 pregnant women with Life- Limiting fetal anomaly diagnosis, 5 family members and 15 perinatal care providers were selected purposefully. Data were gathered by individual interview and were written, important phrases were coded, by grouping same codes, main and sub categories were extracted. Results: In this study, 4 main categories, each with a number of subcategories were extracted. The main categories included: “mental health counseling, support parents to accept and cope with event, ethical consideration during end-of-life care of baby, providing perinatal palliative care)”. Conclusion: The results showed that parents who forcibly or voluntarily continue pregnancy after a wearing of fetal anomalies, have extensive care needs during pregnancy and after birth that are not sufficient ly met. Therefore, it seems that a comprehensive service package of perinatal palliative care appropriate for Iran socio- cultural context is necessary. [ABSTRACT FROM AUTHOR]

Background: Small-for-gestational-age (SGA) is one of the most important conditions, which is associated with the risk of perinatal mortality and morbidity. The levels of pregnancy-associated plasma protein A (PAPP-A) and β-human-derived chorionic gonadotrophic (β-hCG) in the first trimester can predict this adverse outcome, considering the controversial nature of studies in this area, this cohort study was conducted to investigate the role of PAPP-A and freeβ-hCG levels for predicting SGA. Materials and Methods: In this cohort study, from 16 randomly selected health centers in Isfahan, Iran, 4605 volunteer pregnant women who had performed first-trimester fetal anomalies screening tests were chosen based on the census, from July 2016 to June 2018. The multiples of the median (MoM) PAPP-A <0.4 and MoM β-hCG >3 were considered as abnormal; the samples were followed up after childbirth. The biomarkers' serum levels, relative risk, and odds ratio (OR) of SGA were compared in both SGA and appropriate for gestational age (AGA) groups. Results: In the SGA group, the mean of MOM PAPP-A was significantly lower (0.96 vs. 1.1 with P = 0.001) and MoM βhCG was significantly higher (1.24 vs. 1.15 with P = 0.01) than the AGA group. Odds for SGA in subjects with MoM PAPP-A <0.4 were 3.213; P = 0.001 and for subjects with MoM βhCG >3 reported as 0.683; P = 0.111. Conclusion: The results of the study showed that the low levels of PAPP-A would cause 3.213 times increase in the chance of developing SGA and no association between high level of βhCG >3 with SGA. Therefore, low level of the PAPP-A is a warning indicator for SGA. [ABSTRACT FROM AUTHOR]