Advanced maternal age as a sole indication for genetic amniocentesis; risk-benefit analysis based on a large database reflecting the current common practice

Bornstein, Eran; Lenchner, Erez; Donnenfeld, Alan E.; Barnhard, Yoni; Seubert, David; Divon, Michael Y.

doi:10.1515/jpm.2009.032

Cited by 23 publications

(12 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some reports have suggested that maternal age Ն 35 years should not be used as the only indication for off ering invasive diagnostic testing (Berkowitz et al 2006;Hodges and Wallace 2005;Kuppermann and Norton 2005;ACOG 2007). However, Bornstein et al (2009) demonstrated that advanced maternal age is a reasonable indication for invasive prenatal diagnosis, although they acknowledge that this will result in a high rate of invasive procedures. When we evaluated our indications, no abnormality was detected by ultrasonography in 58.9% of the fetuses with chromosomal abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Cytogenetic analysis of 6,142 amniocentesis cases: A 6-year single centre experience

Ekin

Gezer

Taner

et al. 2014

Journal of Obstetrics and Gynaecology

View full text Add to dashboard Cite

The aim of our study was to evaluate the incidences and chromosomal abnormality detection rates of various indications for genetic amniocentesis. We retrospectively analysed 6,142 amniocentesis cases performed in a single centre between January 2007 and April 2013. We assessed the indications for prenatal diagnosis, fetal karyotypes, maternal ages, fetal ultrasound findings and maternal serum screening results. The most common indication for genetic amniocentesis was an abnormal maternal serum-screening test (36.6%), followed by advanced maternal age (28%), advanced maternal age and an abnormal maternal serum screening test (14.9%) and abnormal ultrasound findings (11.2%). The highest positive predictive values obtained from the indications included abnormal ultrasound findings and abnormal maternal serum screening test (12.9%) and advanced maternal age (12.2%). Although advanced maternal age and abnormal maternal serum screening tests were the most common indicators, their association with abnormal ultrasound findings should be identified to increase the efficacy of genetic amniocentesis.

show abstract

Section: Discussionmentioning

confidence: 99%

Cytogenetic analysis of 6,142 amniocentesis cases: A 6-year single centre experience

Ekin

Gezer

Taner

et al. 2014

Journal of Obstetrics and Gynaecology

View full text Add to dashboard Cite

show abstract

“…Despite the recently published guidelines, quite a few obstetricians still consider the age of 35 years as a cutoff for genetic testing [10]. According to recent studies conducted in Colorado of the US, birth rate of children with Down's syndrome increased when frequency of amniocentesis was reduced among women aged 35 years or older [11,12]. Consequently, maternal age is a factor that cannot be completely excluded from examination of fetal chromosomal abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Maternal age-specific rates of fetal chromosomal abnormalities in Korean pregnant women of advanced maternal age

et al. 2013

View full text Add to dashboard Cite

ObjectiveTo evaluate the association of maternal age with occurrence of fetal chromosomal abnormalities in Korean pregnant women of advanced maternal age (AMA).MethodsA retrospective review of the amniocentesis or chorionic villous sampling (CVS) database at Gangnam and Bundang CHA Medical Centers, between January 2001 and February 2012, was conducted. This study analyzed the incidence of fetal chromosomal abnormalities according to maternal age and the correlation between maternal age and fetal chromosomal abnormalities in Korean pregnant women ≥35 years of age. In addition, we compared the prevalence of fetal chromosomal abnormalities between women of AMA only and the others as the indication for amniocentesis or CVS.ResultsA total of 15,381 pregnant women were selected for this study. The incidence of aneuploidies increased exponentially with maternal age (P<0.0001). In particular, the risk of trisomy 21 (standard error [SE], 0.0378; odds ratio, 1.177; P<0.001) and trisomy 18 (SE, 0.0583; odds ratio, 1.182; P=0.0040) showed significant correlation with maternal age. Comparison between women of AMA only and the others as the indication for amniocentesis or CVS showed a significantly lower rate of fetal chromosomal abnormalities only in the AMA group, compared with the others (P<0.0001).ConclusionThis study demonstrates that AMA is no longer used as a threshold for determination of who is offered prenatal diagnosis, but is a common risk factor for fetal chromosomal abnormalities.

show abstract

“…It is estimated that when a woman is 35 years or older (at the time of birth), the risk of miscarriage due to amniocentesis is lower than the probability of having a child with Down's syndrome *Manuscript (must not contain author information) Click here to view linked References 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 (Bornstein et al, 2009). Consequently, advanced maternal age (AMA) is the most common routine indication for genetic counseling during pregnancy (Drugan & Evans, 2006).…”

Section: Advanced Maternal Age and Prenatal Testingmentioning

confidence: 99%

Amniocentesis Due to Advanced Maternal Age: The Role of Marital Intimacy in Couples’ Decision-Making Process

et al. 2011

View full text Add to dashboard Cite

Due to the risk of fetal anomaly, pregnant women of advanced maternal age are given the option to undergo amniocentesis. This study aimed to describe couples' decision-making process regarding amniocentesis, and assess whether it is influenced by marital intimacy and men's attendance of genetic counseling. During pregnancy, 112 couples answered the Personal Assessment of Intimacy in Relationships questionnaire and scales regarding the decision to undergo amniocentesis. Most couples shared and reached an agreement regarding this decision. Higher levels of marital engagement and communication, but not men's attendance, were associated with higher agreement, influence, and decision sharing. Clinical implications are discussed.

show abstract

Advanced maternal age as a sole indication for genetic amniocentesis; risk-benefit analysis based on a large database reflecting the current common practice

Abstract: Our analysis suggests that the benefit of genetic amniocentesis for the sole indication of AMA far outweighs the potential amniocentesis-related fetal loss rate, regardless of the actual rate one considers.

Cited by 23 publications

References 15 publications

Cytogenetic analysis of 6,142 amniocentesis cases: A 6-year single centre experience

Cytogenetic analysis of 6,142 amniocentesis cases: A 6-year single centre experience

Maternal age-specific rates of fetal chromosomal abnormalities in Korean pregnant women of advanced maternal age

Amniocentesis Due to Advanced Maternal Age: The Role of Marital Intimacy in Couples’ Decision-Making Process

Contact Info

Product

Resources

About