Document Detail


First-trimester Down syndrome screening performance in the Dutch population; how to achieve further improvement?
MedLine Citation:
PMID:  19294632     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the performance of the first-trimester combined test between 2004 and 2006 compared to a previous period to investigate changes in time and identify reasons for sub-optimal performance. METHODS: Serum samples were analysed for pregnancy-associated plasma protein A (PAPP-A) and the free beta subunit of human chorionic gonadotrophin (f beta-hCG). Nuchal translucency (NT) was measured between 10 and 14 weeks. Tests were considered screen positive, if their calculated Down syndrome (DS) risk was at least 1 in 250 at term. RESULTS: A total of 20,293 singleton pregnancies were included in the analysis. The median maternal age fell from 35.7 to 34.3 years. The overall median weight-corrected multiple of the median (MoM) values of PAPP-A and f beta-hCG were 1.12 and 1.03, respectively. The median MoM value of NT was 0.89 and increased from 0.82 to 0.96. Sixty-six DS cases were detected by the screening test. The detection rate (DR) for DS was 75.9%, with a FPR of 3.3%. CONCLUSION: The performance of the first-trimester test has improved over the years. A better performance of the NT measurement was the main reason, although NT assessment should further be improved. In addition, a better setting of the medians for the biochemical parameters may contribute to a higher DR.
Authors:
E J Wortelboer; M P H Koster; Ph Stoutenbeek; L H Elvers; J G Loeber; G H A Visser; P C J I Schielen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  29     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-02     Completed Date:  2009-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  588-92     Citation Subset:  IM    
Copyright Information:
(c) 2009 John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3508 AB Utrecht, The Netherlands. E.Wortelboer@umcutrecht.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Chorionic Gonadotropin, beta Subunit, Human / blood
Down Syndrome / diagnosis*
Female
Humans
Mass Screening / methods*
Middle Aged
Netherlands
Nuchal Translucency Measurement
Pregnancy
Pregnancy Trimester, First*
Pregnancy-Associated Plasma Protein-A / analysis
Young Adult
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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