Performance and Predictive Value of First Trimester Screening Markers for Down Syndrome in Iranian Pregnancies (original) (raw)
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Down syndrome screening methods in Iranian pregnant women
Journal of caring sciences, 2012
Down syndrome is one of the most prevalent genetic diseases. Screening methods for this syndrome are easy and safe and are recommended to all pregnant women particularly mothers over 35 years of age. This study aimed to review the status of Down syndrome screening and related factors in Iranian pregnant women. This descriptive analytical study was carried out in 2011. It included 400 women who were randomly selected from those referring to Alzahra Hospital (Tabriz, Iran) during their third trimester of pregnancy. Data was collected through a question-naire whose reliability and validity have been approved. The data was analyzed by chi-square test in SPSS13. The results showed that while 28 and 26 women imple-mented screening tests during the first and second trimesters, respectively, only 5 sub-jects benefited from both (integrated test). Chi-square test showed significant correla-tions between the implementation of screening methods and age, education level, in-come, and the locati...
Türk biyokimya dergisi, 2022
Objectives: This study aimed to evaluate the effect size of each parameter used in the first trimester Down Syndrome (DS) risk analyses by using multiple regression analysis techniques. Methods: This data mining study included data of 44,260 pregnant women screened at the Acibadem Labmed laboratories from 2010 to 2019. In this study, risk was calculated using the PRISCA software on the basis of nuchal translucency (NT), crown-rump length measurement, in vitro fertilization application, diabetes mellitus, Down Syndrome story, smoking, maternal age, and the level of maternal serum biochemistry markers including pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (hCGβ). Results: Forty-four thousand two hundred sixty risk analysis patients result data were re-investigate, and 851 (1.93%) risk analysis results were found as positive. PAPP-A 747 (CI%, 476-1,170) times, NT value 512 (CI%, 343-764) times, DS story 21 times (CI%, 6.7-63.2) and hCGβ value 7.01 (CI%, 6.31-7.79) times affect the combined firsttrimester risk analysis results. Conclusions: We have suggested that those accurate PAPP-A levels and NT levels evaluation are the most critical point of combined risk analysis and that the risk of free hCGβ levels after PAPP-A is essential as a biochemical test. Keywords: data mining; first trimester Down Syndrome (DS) risk analyses; free beta-human chorionic gonadotropin (hCGβ); nuchal translucency (NT); pregnancy-associated plasma protein-A PAPP-A.
Down syndrome maternal serum marker screening after 18 weeks of gestation: a countrywide study
American Journal of Obstetrics and Gynecology, 2013
The objective of the study was to evaluate the efficacy of maternal serum markers in detecting Down syndrome after 18 weeks of gestation in women who book late for maternity care in a large national retrospective study. STUDY DESIGN: During the period 2007-2012, 27,648 women, regardless of maternal age (17.4% were 35 years old and over), were included in a late Down syndrome screening program (18 ϩ0 to 35 ϩ6 weeks) using the maternal serum markers alpha-fetoprotein and human chorionic gonadotrophin-beta. Samples were assayed in a single laboratory. A dataset of median markers previously established in our laboratory was used for risk calculation. The control group consisted of 27,648 women (14 ϩ0 to 17 ϩ6 weeks) randomly selected from the routine database. RESULTS: When the later screening group was compared with the standard second-trimester control group, the median multiples of medians (1.01 vs 0.98 for alpha-fetoprotein, 1.03 vs 0.98 for human chorionic gonadotrophin-beta), median risks (1 of 2414 vs 1 of 2720), false-positive rates (11.1% vs 11.6%), and trisomy 21 detection rates (83.3% vs 85.7%) did not differ significantly. CONCLUSION: Late Down syndrome maternal serum screening is feasible with a good sensitivity/specificity compromise throughout gestation and is of clinical value in late-booking women.
Turkish Journal of Biochemistry
Objectives This study aimed to evaluate the effect size of each parameter used in the first trimester Down Syndrome (DS) risk analyses by using multiple regression analysis techniques. Methods This data mining study included data of 44,260 pregnant women screened at the Acibadem Labmed laboratories from 2010 to 2019. In this study, risk was calculated using the PRISCA software on the basis of nuchal translucency (NT), crown-rump length measurement, in vitro fertilization application, diabetes mellitus, Down Syndrome story, smoking, maternal age, and the level of maternal serum biochemistry markers including pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (hCGβ). Results Forty-four thousand two hundred sixty risk analysis patients result data were re-investigate, and 851 (1.93%) risk analysis results were found as positive. PAPP-A 747 (CI%, 476–1,170) times, NT value 512 (CI%, 343–764) times, DS story 21 times (CI%, 6.7–63.2) and hCGβ value 7...
Down’s Syndrome Screening in the First Trimester with Additional Serum Markers: Indian Parameters
The Journal of Obstetrics and Gynecology of India
Objective To derive a risk calculation algorithm suitable for use in India when screening for Down's syndrome using four first-trimester maternal serum markers either alone or with ultrasound nuchal translucency (NT). Methods Stored maternal serum samples (-20°C) from 411 singleton unaffected pregnancies were retrieved and measured for pregnancy-associated plasma protein (PAPP-A), free b-human chorionic gonadotropin (hCG), placental growth factor and a-fetoprotein. Samples were taken at
Combining first and second trimester markers for Down syndrome screening: Think twice
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2008
This study compares different screening strategies for the detection of Down syndrome and considers practical implications of using multiple screening protocols. Methods: The performance characteristics of each screening strategy were assessed based on datasets of Down syndrome (n = 11) and unaffected pregnancies (n = 1006) tested in both first and second trimester, as well as data from first trimester (n = 18 901) and second trimester (n = 40 748) pregnancies. Results: For a detection rate of 91%, the false positive rates for integrated and serum integrated screening were 2.5% and 6.3%, respectively, compared with combined first trimester (4.6%) and second trimester (12.6%) screening. Contingent and sequential screening protocols achieved detection rates of 82 to 91% with false positive rates between 2.6 and 2.9%. Contingent protocols require retesting of 15 to 20% of cases in the second trimester. Sequential and integrated protocols require retesting of 98 to 100% of cases in the second trimester. The various screening strategies did not always detect the same Down syndrome pregnancies. Conclusions: Combining first and second trimester markers for Down syndrome screening better defines the at-risk population. However, integrated protocols complicate management of screening programs and may not be suitable as primary screening strategies. It may be a better use of resources to refine current first and second trimester programs through improved access and new markers. We therefore suggest thinking twice before embracing integrated population screening programs.
A prospective two years study of first trimester screening for Down syndrome
Hippokratia, 2008
Nowadays maternal age of pregnant women has increased in most developed countries. The rate of women above 35 years old constitutes about 15% of pregnancies. The aim of our study is to prove that by first trimester screening, the number of women who have indication for invasive prenatal diagnostic procedure is significantly reduced. This prospective study lasted two years from 02/2005 to 02/2007. The participants to our study were 531 pregnant women with a mean maternal age of 30 years (19-42). We used the first trimester screening test for Down's syndrome. The biochemical blood test of free b-hCG (beta human chorionic gonadotropin) and PAPP-A (pregnancy associated plasma protein A) and the measurement of nuchal translucency were performed between 11-13 weeks +6 days (mean gestational age 12 weeks +2 days). In our study group, 69 women (12%) were 35 years old or more. The risk estimate for Down syndrome was 1 in 300 or more in 14 (2%) cases. In all these 14 cases we offered CVS ...
Maternal serum screening for Down's syndrome in the first trimester of pregnancy
BJOG: An International Journal of Obstetrics and Gynaecology, 1995
Biochemical screening for Down's syndrome usually takes place in the second trimester of pregnancy. If effective maternal serum screening could be carried out in the first trimester, prenatal diagnosis using chorionic villous sampling (CVS) would allow for the identification of trisomy 21, and thus early pregnancy termination. Several studies have shown that alpha-fetoprotein and unconjugated oestriol (uE,) serum levels decrease in Down's syndrome pregnancies during the first trimester , while human chorionic gonadotrophin (hCG) levels are within the normal range ). In contrast with hCG, free PhCG subunit levels have been found to be increased significantly in first trimester maternal serum from Down's syndrome pregnancies .