Document Detail


Meta-analysis of first trimester Down syndrome screening studies: free beta-human chorionic gonadotropin significantly outperforms intact human chorionic gonadotropin in a multimarker protocol.
MedLine Citation:
PMID:  17346522     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to compare free beta and intact human chorionic gonadotropin in first trimester screening with pregnancy-associated plasma protein-A and nuchal translucency. STUDY DESIGN: A Monte Carlo simulation trial was conducted based on a literature review of the PUBMED database (1966 to November 2005). RESULTS: In younger patients (< 35 years), detection of Down syndrome increased by 4, 5, 6, and 7 percentage points when free beta was added to pregnancy-associated plasma protein-A and nuchal translucency compared with 0, 0, 2, and 4 percentage points for intact human chorionic gonadotropin at 9-12 weeks' gestation, respectively. In advanced maternal age patients (> or = 35), inclusion of free beta-human chorionic gonadotropin reduced the false-positive rate by 2.5, 3.1, 3.8, and 4.4 percentage points compared with 0.1, 0.3, 1.0, and 2.2 percentage points for intact human chorionic gonadotropin at 9-12 weeks, respectively. CONCLUSION: The results of our analysis suggest that in a first-trimester Down syndrome screening protocol free beta-human chorionic gonadotropin achieves higher sensitivity and lower false-positive results than intact human chorionic gonadotropin . Moreover, intact human chorionic gonadotropin does not add substantially to screening performance until the end of the first trimester.
Authors:
Mark I Evans; David A Krantz; Terrence W Hallahan; Robert S Galen
Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  196     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-05-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  198-205     Citation Subset:  AIM; IM    
Affiliation:
Comprehensive Genetics, and Mt Sinai School of Medicine, New York, NY 10021, USA. Evans@Compregen.com
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Chorionic Gonadotropin / blood*
Chorionic Gonadotropin, beta Subunit, Human / blood*
Clinical Protocols
Down Syndrome / diagnosis*
Female
Humans
Pregnancy
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / analysis*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin; 0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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


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