Document Detail


Identification of second trimester screen positive pregnancies at increased risk for congenital heart defects.
MedLine Citation:
PMID:  19266536     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine whether second trimester biomarkers could be used to identify screen positive pregnancies at increased risk for congenital heart defects (CHDs) and measure the effect of using different biomarker cut points on the detection of CHDs and on the performance of predictive models. METHODS: Included were 19,402 pregnancies without chromosomal defects, which were screen positive for Down syndrome or other birth defects based on maternal serum measurements of alpha-fetoprotein (AFP), human chorionic gonadotrophin (hCG), and unconjugated estriol (uE3). Logistic regression models were built that compared biomarkers for CHD cases compared to controls. RESULTS: CHD cases were more likely to be screen positive for trisomy-18, to have a nuchal fold (NF) >or= 5 mm, and/or to have an hCG multiple of the median (MoM) >or= 95th percentile in models that considered screen positive grouping. In models that did not consider screen positive grouping, cases were more likely to have a NF >or= 5 mm, an AFP MoM <or=10th percentile, an hCG MoM <or=25th percentile, and/or an hCG MoM >or= 75th percentile. CONCLUSION: Along with NF, second trimester maternal serum biomarkers may be useful indicators for fetal and newborn evaluation for CHDs in screen positive pregnancies without identified chromosomal defects.
Authors:
Laura L Jelliffe-Pawlowski; Lynn Walton-Haynes; Robert J Currier
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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:  570-7     Citation Subset:  IM    
Copyright Information:
(c) 2009 John Wiley & Sons, Ltd.
Affiliation:
Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA. Laura.Jelliffe@cdph.ca.gov
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MeSH Terms
Descriptor/Qualifier:
Adult
Biological Markers / blood
Case-Control Studies
Chorionic Gonadotropin, beta Subunit, Human / blood
Chromosomes, Human, Pair 18*
Estriol / blood
Female
Heart Defects, Congenital / blood*,  diagnosis
Humans
Nuchal Translucency Measurement*
Odds Ratio
Pregnancy
Pregnancy Trimester, Second / blood*
Sensitivity and Specificity
Trisomy*
alpha-Fetoproteins / analysis*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin, beta Subunit, Human; 0/alpha-Fetoproteins; 50-27-1/Estriol

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