Document Detail


Maternal urine and serum steroid measurements to identify steroid sulfatase deficiency (STSD) in second trimester pregnancies.
MedLine Citation:
PMID:  19418464     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To document the performance of second trimester maternal urine and serum steroid measurements for detecting fetal steroid sulfatase deficiency (STSD). METHODS: We studied detection rate and false positive rate (DR, FPR) of analytes in maternal urine [combinations of 16alpha-OH-dehydroepiandrosterone sulfate (16alpha-OH-DHEAS), 11beta-hydroxyandrosterone, total estriol] and serum [combinations of 16alpha-OH-DHEAS, 11beta-hydroxyandrosterone, total estriol, unconjugated estriol (uE3)]. Samples were obtained from pregnancies which were screen positive for Smith-Lemli-Opitz syndrome (SLOS). RESULTS: Among 1 079 301 pregnancies, 3083 (0.29%) were screen positive for SLOS. Urine and/or serum samples were available from 917 viable pregnancies with known gender. We assigned likelihood ratios (LRs) to steroid measurements from male fetuses with known STSD and unaffected female fetuses. An LR > or = 100 was present in urine from 84 of 86 STSD pregnancies (98% DR, 95% CI 92-99), along with 0 of 198 pregnancies with normal female fetuses (0.0% FPR, CI 0-1.9). LRs were > or = 100 in 4 of 129 female fetuses with major abnormalities (3% FPR). In maternal serum, steroid measurements performed less effectively, achieving a 71% DR for STSD at a 1.6% FPR. CONCLUSION: Maternal urine steroid measurements are effective for detecting STSD, including those with point mutations and those with full deletions.
Authors:
Josep Marcos; Wendy Y Craig; Glenn E Palomaki; Edward M Kloza; James E Haddow; Marie Roberson; Linda A Bradley; Cedric H L Shackleton
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  29     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-30     Completed Date:  2009-10-27     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  771-80     Citation Subset:  IM    
Affiliation:
Children's Hospital Oakland Research Institute, Oakland, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Androsterone / analogs & derivatives*,  blood,  metabolism,  urine
Dehydroepiandrosterone / analogs & derivatives*,  blood,  metabolism,  urine
Estriol / blood,  metabolism*,  urine
False Positive Reactions
Female
Gas Chromatography-Mass Spectrometry
Gene Deletion
Humans
Ichthyosis, X-Linked*
Male
Point Mutation
Predictive Value of Tests
Pregnancy
Pregnancy Trimester, Second / blood*,  urine*
Prenatal Diagnosis
Smith-Lemli-Opitz Syndrome / blood,  diagnosis*,  urine
Steryl-Sulfatase / metabolism
Grant Support
ID/Acronym/Agency:
HD 38940/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
28905-55-7/16-hydroxydehydroepiandrosterone sulfate; 50-27-1/Estriol; 53-41-8/Androsterone; 53-43-0/Dehydroepiandrosterone; 57-61-4/11 beta-hydroxyandrosterone; EC 3.1.6.2/Steryl-Sulfatase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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