Different median levels of serum triple markers in the second trimester of pregnancy in a Thai Ethnic Group

Wanapirak, Chanane; Sirichotiyakul, Supatra; Luewan, Suchaya; Yanase, Yuri; Traisrisilp, Kuntharee; Tongsong, Theera

doi:10.1111/j.1447-0756.2011.01769.x

Cited by 8 publications

(5 citation statements)

References 18 publications

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“…In real practice, the patients were managed using the screening based on Caucasian reference ranges (CRR) as mentioned above. However, the data permitted us to re-categorize the primary screening into several models, using Thai reference ranges (TRR) [14, 15], as follows: 1) Maternal age alone: High risk if maternal age is up to 35 years or more; 2) STS (second trimester screening) alone: The risk derived from serum levels of AFP, free b-hCG and uE3; 3) FTS (first trimester screening): The risk derived from serum levels of PAPP-A and free b-hCG; 4) Contingent FTS screening (C-S): The risk derived from serum levels of PAPP-A and hCG) and categorized into three groups according to the risk as mentioned above; 5) C-S plus STS: Contingent FTS for women with first visit in the first trimester and STS alone for women with first visit in the second trimester; 6) Independent FTS and STS (I-S): FTS alone for women with first visit in the first trimester and STS alone for women with first visit in the second trimester.…”

Section: Methodsmentioning

confidence: 99%

Fetal Down syndrome screening models for developing countries; Part I: Performance of Maternal Serum Screening

Wanapirak

Piyamongkol

Sirichotiyakul

et al. 2019

BMC Health Serv Res

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BackgroundTo identify the performance of fetal Down syndrome (DS) screening for developing countries.MethodsA prospective study on MSS (maternal serum screening) with complete follow-ups (n = 41,924) was conducted in 32 network hospitals in the northern part of Thailand. Various models of MSS were tested for performance.ResultsMSS based on Caucasian reference range resulted in very high false positive rate (FPR; 13%) in our country, compared to the rate of 7.8% with our own (Thai) reference range, whereas the detection rate was comparable. As individual screening, C-S (contingent first trimester screening including PAPP-A, and free beta-hCG, classified as a) high risk [> 1:30], indicated for invasive diagnosis; b) intermediate risk [1:30–1500], indicated for STS; and c) low risk [< 1:1500], need no further tests.) was the most effective model (sensitivity 84.9%, FPR 7.7%) but nearly one-third needed the second trimester test (STS) because of intermediate results. Additionally, about one-third had their first visits in the second trimester and had no chance of FTS (first trimester screening). C-S plus STS had a sensitivity of 82.4% and FPR 8.1% whereas independent first and second trimester screening model (I-S) gave the sensitivity of 78.4% and FPR of 7.5% but was much more convenient and practical.ConclusionC-S plus STS was the most effective models while I-S model was also effective and may be better for developing countries because of its simplicity and feasibility.

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Section: Methodsmentioning

confidence: 99%

Fetal Down syndrome screening models for developing countries; Part I: Performance of Maternal Serum Screening

Wanapirak

Piyamongkol

Sirichotiyakul

et al. 2019

BMC Health Serv Res

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“…Unconjugated Estriol (UE) is currently used as a component of Down syndrome diagnostic tests in pregnancy (30). Moreover, the serum UE concentration is associated with factors such as the mother's weight, gestational age, and race (31).…”

Section: Discussionmentioning

confidence: 99%

Predictive Power of Unconjugated Estriol in Diagnosis of Gestational Diabetes: A Cohort Study

Amirian¹,

Kariman²,

Hedayati³

et al. 2019

Iran Red Crescent Med J

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Background: Gestational diabetes is the most common antenatal medical complication that is associated with adverse short-and long-term maternal, fetal, and neonatal outcomes. Reducing maternal and fetal complications requires the early diagnosis of gestational diabetes. Unconjugated Estriol (UE) has led to insulin resistance under in vitro conditions. Objectives: This study aimed to determine the predictive power of unconjugated estriol in the diagnosis of gestational diabetes in Tehran, Iran. Methods: The present historical cohort study was conducted on 523 pregnant women presenting to two university-affiliated hospitals in Tehran, Iran, 2017-2018. The level of unconjugated estriol was determined at the 14th-17th week of pregnancy, and gestational diabetes was diagnosed at the 24th-28th week of pregnancy using the oral glucose tolerance test with 75 grams of glucose. Data were collected through interviews and sampling was carried out using a convenience sampling method. Results: Out of 523 pregnant women examined, 63 (12%) were placed in the gestational diabetes group and 460 (88%) in the nongestational diabetes group. The best cutoff point for unconjugated estriol was determined using the ROC curve as 0.965 MOM. We obtained 66.66% sensitivity, 54.78% specificity, 16.8% positive predictive value, and 92.30 negative predictive value for the UE test. Conclusions: Given the acceptable sensitivity (66.66%) and specificity (54.78%) obtained for the UE test and the area under the ROC curve of 0.60, it appears that the UE test can be considered a new, accessible, and reliable screening test for gestational diabetes.

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“…9,10 The effects of gestational age and maternal weight were consistent with previously published data from other platforms. 11,12 Maternal weight is another influential determinant of these serum marker levels, displaying negative affiliations. The pathophysiology behind these affiliations is at present indistinct.…”

Section: Discussionmentioning

confidence: 99%

Normative Values of Second-Trimester Maternal Serum Markers Using an Automated Assay Platform for Down Syndrome Screening

Russameecharoen

Nawapun

Phattanachindakun

et al. 2019

Smj

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Objective: Automated chemiluminescent immunoassay has several advantages over manual ELISA with comparable test performance. Few studies have reported the reference values of the second-trimester serum markers maternal serum alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A (Inh A) by automated immunoassay in Asian population. Accordingly, this study aimed to determine the median values of second trimester serum markers as a function of gestational age (GA) in Thai population using an automated immunoassay. Methods: This prospective cross-sectional study of serum markers in healthy singleton second trimester (14-22 weeks) pregnant women was conducted at Siriraj Hospital from September 2012 to April 2015. Maternal serum AFP, hCG, uE3, and Inh A were analyzed by automated immunoassay. Predicted median values as a function of GA were calculated from best-fit regression equations. Results: A total of 1,526 women were included. Median values serum markers were constructed from the following optimal models: AFP (ng/mL) = 99.082-14.195 GA + 0.662 GA 2 , r 2 =0.995; hCG (mIU/mL) = 390168.106-35 968.397GA + 876.708GA 2 , r 2 =0.972; uE3 (ng/mL) =-3.388 + 0.274 GA, r 2 =0.997; and, Inh-A (pg/mL) = 1206.875-114.171 GA + 3.174 GA 2 , r 2 =0.882. Using the same platform analysis and maternal weight adjustment, the reference values in Thai population were shown to be different from those of other ethnicities. Conclusion: Median values of second-trimester serum markers for Thai population were determined. Maternal weight and the use of population-specific normal values have to be taken into account for Down syndrome screening in the second trimester.

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Different median levels of serum triple markers in the second trimester of pregnancy in a Thai Ethnic Group

Cited by 8 publications

References 18 publications

Fetal Down syndrome screening models for developing countries; Part I: Performance of Maternal Serum Screening

Fetal Down syndrome screening models for developing countries; Part I: Performance of Maternal Serum Screening

Predictive Power of Unconjugated Estriol in Diagnosis of Gestational Diabetes: A Cohort Study

Normative Values of Second-Trimester Maternal Serum Markers Using an Automated Assay Platform for Down Syndrome Screening

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