| A prospective evaluation of a second-trimester screening test for fetal Down syndrome using maternal serum alpha-fetoprotein, hCG, and unconjugated estriol. | |
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MedLine Citation:
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PMID: 7677967 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To test the efficacy of a screening protocol using a combination of maternal age plus three biochemical markers--maternal serum alpha-fetoprotein (MSAFP), hCG, and unconjugated estriol (E3)--for the antenatal detection of fetal Down syndrome. METHODS: We conducted a prospective cohort study of 7718 women who underwent the triple-marker analysis between weeks 15-18 of pregnancy. A second-trimester risk for Down syndrome of 1:195 or greater was considered positive. Sensitivity, specificity, positive predictive value, and their 95% confidence intervals (CIs) were calculated. We evaluated test performance for various maternal age groups and screen-positive cutoffs, as well as the relative screening efficacies of maternal age and MSAFP, MSAFP plus hCG, and MSAFP, hCG, and unconjugated E3. RESULTS: Four hundred sixty-one of the 7718 women screened (6%) were identified as positive; 319 women chose amniocentesis, for an overall amniocentesis rate of 4.1%. Twenty of 22 pregnancies affected with Down syndrome were correctly identified, as were 7255 of 7696 unaffected pregnancies, yielding a sensitivity and specificity of 91% (95% CI 79-100%) and 94% (95% CI 93.8-94.8%), respectively. The use of maternal age plus all three analytes improved test performance compared with maternal age plus MSAFP and hCG, but either had a significantly improved detection rate compared with that for maternal age and MSAFP alone. CONCLUSION: The triple-marker screen appears to be an effective method of detecting Down syndrome pregnancies while maintaining an acceptable amniocentesis rate. |
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Authors:
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E Y Cheng; D A Luthy; A M Zebelman; M A Williams; R E Lieppman; D E Hickok |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 81 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 1993 Jan |
Date Detail:
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Created Date: 1993-01-21 Completed Date: 1993-01-21 Revised Date: 2009-10-26 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 72-7 Citation Subset: AIM; IM |
Affiliation:
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Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amniocentesis Chorionic Gonadotropin / blood* Chromosome Aberrations / diagnosis Chromosome Disorders Down Syndrome / diagnosis* Estriol / blood* Female Fetal Diseases / diagnosis Humans Maternal Age Predictive Value of Tests Pregnancy Prenatal Diagnosis* Prospective Studies Sensitivity and Specificity alpha-Fetoproteins / analysis* |
| Grant Support | |
ID/Acronym/Agency:
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MCJ41102-07//PHS HHS |
| Chemical | |
Reg. No./Substance:
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0/Chorionic Gonadotropin; 0/alpha-Fetoproteins; 50-27-1/Estriol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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