Document Detail


The effect of fetal gender on the prediction of Down syndrome by means of maternal serum alpha-fetoprotein and ultrasonographic parameters.
MedLine Citation:
PMID:  7694466     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our investigation was designed to use maternal serum alpha-fetoprotein and individual or combinations of ultrasonographic parameters to examine the influence of fetal gender on the prediction of Down syndrome. STUDY DESIGN: A cohort study of 5114 patients who underwent karyotype analysis between 13 and 22 weeks' gestation was undertaken. Maternal demographic variables, anthropometric indices, and maternal serum alpha-fetoprotein values were assessed. Fetal parameters recorded included gender, biparietal diameter, head circumference, femoral and humeral length, transverse cerebellar diameter, and nuchal fold thickness. The effect of fetal gender on maternal serum alpha-fetoprotein values and ultrasonographic parameters was assessed. Gender-specific differences between fetuses with Down syndrome and euploid fetuses were identified, and the optimal cutoff values of individual and combinations of biometric parameters were determined by receiver operating characteristic curve analysis. RESULTS: A total of 42 fetuses with Down syndrome were identified. Female fetuses with Down syndrome had significantly lower maternal serum alpha-fetoprotein values than their male counterparts, and maternal serum alpha-fetoprotein screening paradigms resulted in the disproportionate identification of affected female fetuses. A nuchal fold thickness > or = 5 mm was the single best ultrasonographic predictor of Down syndrome independent of fetal gender. Affected male fetuses had significantly smaller mean femoral and humeral lengths than euploid fetuses after adjustment for biparietal diameter, but only the humeral length proved a clinically useful predictor of Down syndrome. Pearson's correlation coefficient confirmed that nuchal fold thickness and humeral length were independent of each other and of maternal age and maternal serum alpha-fetoprotein levels. The optimal ultrasonographic predictor of Down syndrome was the presence of either a nuchal fold thickness > or = 6 mm or a humeral length > 3.5 to 3.7 mm below the expected value. This combination of ultrasonographic findings identified 41.7% of female and 66.7% of male fetuses with Down syndrome. CONCLUSIONS: Fetal gender affects the prediction of Down syndrome by both maternal serum alpha-fetoprotein and ultrasonographic parameters. Moreover, the ultrasonographic detection of Down syndrome in fetuses is greatly improved by a combination of gender-specific biometric parameters.
Authors:
C J Lockwood; L Lynch; A Ghidini; R Lapinski; G Berkowitz; B Thayer; W A Miller
Related Documents :
7327586 - Quantitative and qualitative assay of amniotic-fluid acetylcholinesterase in the prenat...
2237476 - The fetal central nervous system.
22524456 - Risk for recurrence of preeclampsia and outcome of subsequent pregnancy in women with p...
7820716 - Use of local neural tube defect registers to interpret national trends.
18586876 - Shared genetic determinant of axial length, anterior chamber depth, and angle opening d...
10342846 - Transgenic mice with chronically elevated luteinizing hormone are infertile due to anov...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  169     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-12-15     Completed Date:  1993-12-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1190-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY 10029.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Biometry
Down Syndrome / blood*,  ultrasonography*
Female
Femur / embryology
Fetus / physiology*
Forecasting
Humans
Male
Pregnancy / blood*
Prenatal Diagnosis
Reference Values
Regression Analysis
Sex Characteristics*
Ultrasonography, Prenatal
alpha-Fetoproteins / analysis*
Chemical
Reg. No./Substance:
0/alpha-Fetoproteins

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


Previous Document:  Evaluation of plasma insulin-like growth factor-binding protein-3 as a potential predictor of preecl...
Next Document:  Nitric oxide synthase activity in pregnant rabbit uterus decreases on the last day of pregnancy.