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Certain Medications May Alter Quad Screen Results

Last Updated: December 28, 2009.

A pregnant woman's use of certain prescription drugs may skew results of the standard Quad screening and increase the rate of screen-positives for neural tube defects, according to a study in the December issue of the American Journal of Obstetrics & Gynecology.

MONDAY, Dec. 28 (HealthDay News) -- A pregnant woman's use of certain prescription drugs may skew results of the standard Quad screening and increase the rate of screen-positives for neural tube defects, according to a study in the December issue of the American Journal of Obstetrics & Gynecology.

Dawn M. Pekarek, M.D., of the University of Alabama at Birmingham, and colleagues performed a study of 1,337 pregnant women who took at least one prescription medication and received a standard Quad screen for levels of alpha-fetoprotein (AFP), estriol, human chorionic gonadotropin (hCG), and inhibin A. To determine if medication classes are associated with Quad screen analyte levels or screen-positive rates, the results were compared to a control group of 4,869 pregnant women not taking a prescription.

The researchers found that women taking antihypertensives, asthma medications, antidepressants, antiepileptics, and analgesics had higher inhibin A levels, while women taking antiemetics had increased levels of hCG. Women taking immunosuppressants had higher AFP and lower estriol levels, and methadone was associated with a reduction in levels of both estriol and hCG. Positive rates for neural tube defects were higher than in the control group for those taking immunosuppressants (12.8 versus 1.5 percent), antibiotics (4.8 versus 1.5 percent), and antidepressants (3.4 versus 1.5 percent).

"Although our study has demonstrated a possible effect of medications on maternal serum screening, further studies will be needed to confirm this data before using this in clinical practice, including genetic counseling," the authors write.

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