There have been a number of studies evaluating the association of
aneuploidy serum markers with adverse pregnancy outcome. More recently, the development of potential treatments for these adverse outcomes as well as the introduction of cell-free fetal
DNA (cffDNA) screening for
aneuploidy necessitates a re-evaluation of the benefit of
serum markers in the identification of adverse outcomes. Analysis of the literature indicates that the
serum markers tend to perform better in identifying pregnancies at risk for the more severe but less frequent form of individual
pregnancy complications rather than the more frequent but milder forms of the condition. As a result, studies which evaluate the association of
biomarkers with a broad definition of a given condition may underestimate the ability of such markers to identify pregnancies that are destined to develop the more severe form of the condition. Consideration of general population screening using cffDNA solely must be weighed against the fact that traditional screening using
serum markers enables detection of severe
pregnancy complications, not detectable with cffDNA, of which many may be amenable to treatment options.