Özet:

Objective: It was aimed to evaluate the predictivity of antenatal screening test parameters of pregnant women who had stillbirth due to intrauterine fetal demise according to maternal age and gestational birth weeks by retrospectively analysis in our study. Material and Methods: This retrospective cohort study included a total of 394 pregnant women who had a stillbirth due to intrauterine fetal demise at 20 weeks of gestation or later at the University of Health Sciences, Ankara Dr. Zekai Tahir Burak Women Health Education and Research Hospital between January 1, 2017, and June 15, 2019. Patients' demographic characteristics, birth characteristics, and antenatal screening test (combined, triple test) parameters (nuchal transparency [NT], free beta-human coronic gonadotropin [β-hCG], plasma protein-A [PAPP-A], hCG, unconjugated estriol [uE3], serum alpha-fetoprotein [ΑFP] multiples of median [MoM] values) were compared in separate groups of under and above 35 years of age and 20-34 weeks and above 34 weeks of gestation. Additionally, the correlation of antenatal screening test parameters with gestational week was evaluated. Data analysis was carried out using the SPSS version 26.0 statistical software package. Kolmogorov-Smirnov, Mann-Whitney U and Pearson Chi-Square tests were used for statistical analyses. Correlation analysis was performed using Spearman's correlation test. A p-value of <0.05 was considered statistically significant. Results: There was no statistically significant difference between groups under and above 35 years of age in terms of antenatal test parameters MoM values, gestational week, mode of delivery, and birth weight (p=0.230, p=0.214, p=0.129, p=0.644, p=0.473, p=0.537, p=0.098 and p=0.154). There was no statistically significant difference between the groups of 20-34 weeks and above 34 weeks of gestation in terms of antenatal test parameters MoM values (p=0.761, p=0.061, p=0.602, p=0.179 and p=0.120). There was no statistically significant correlation between gestational birth week and the combined test β-hCG, PAPP-A, NT, triple test hCG, uE3 and AFP MoM values (r=0.034, p=0.763, r=-0.210, p=0.060, r=-0.083, p=0.464, r=-0.057, p=0.181 and r=0.164, p=0.120). Conclusion: Clinicians should be careful about adverse pregnancy outcomes in cases of first-trimester increased NT, low free β-hCG, and PAPP-A, and second-trimester increased AFP, hCG, and dimeric inhibin alpha. However, there is currently no definitive laboratory test that has been demonstrated to be useful for predicting stillbirth in clinical practice. The identifiable combination of serum markers does not perform as well as a screening test for stillbirth at this stage. There is a need for large cohort studies with standardized screening test parameters and results.

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