First and second trimester antenatal screening for Down's syndrome: the results of the Serum, Urine and Ultrasound Screening Study (SURUSS)

Abstract

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First‐trimester screening for trisomy 21 by free beta‐human chorionic gonadotropin and pregnancy‐associated plasma protein‐A: impact of maternal and pregnancy characteristics

“…Similarly, 38 167 pregnancies were recruited in the First-and SecondTrimester Evaluation of Risk (FASTER) study, including 117 with trisomy 21, and free β-hCG and PAPP-A were measured retrospectively in stored samples from 79 trisomy 21 pregnancies and 395 matched unaffected controls 17 . Compared with our findings, the difference between trisomy 21 and unaffected pregnancies in free β-hCG in the SURUSS was overestimated by 8% at 11 weeks and by 19% at 13 weeks, and in the FASTER study it was underestimated by 34% and 19%, respectively 16,17 . The difference in PAPP-A in both previous studies was underestimated by 11% at 11 weeks and overestimated by 18% at 13 weeks 16,17 .…”

“…Compared with our findings, the difference between trisomy 21 and unaffected pregnancies in free β-hCG in the SURUSS was overestimated by 8% at 11 weeks and by 19% at 13 weeks, and in the FASTER study it was underestimated by 34% and 19%, respectively 16,17 . The difference in PAPP-A in both previous studies was underestimated by 11% at 11 weeks and overestimated by 18% at 13 weeks 16,17 . In our study, the modeled SD of PAPP-A in unaffected pregnancies was 3-12% lower and in trisomy 21 cases it was 16-20% lower than in previous reports 16,17 .…”

“…In trisomy 21 pregnancies the median MoM free β-hCG increased from 1.80 at 11 weeks to 2.09 at 13 weeks, and the respective values for PAPP-A were 0.38 and 0.65 MoMs. These values derived from our large prospective study, in which the biochemical tests were carried out in all 96 803 cases, are different from those reported in two previous multicenter studies in the UK and USA 16,17 . The Serum, Urine and Ultrasound Screening Study (SURUSS) recruited 47 053 pregnancies, including 101 with trisomy 21, but measured free β-hCG and PAPP-A retrospectively in stored samples from 98 trisomy 21 pregnancies and 1090 matched unaffected controls 16 .…”

“…These values derived from our large prospective study, in which the biochemical tests were carried out in all 96 803 cases, are different from those reported in two previous multicenter studies in the UK and USA 16,17 . The Serum, Urine and Ultrasound Screening Study (SURUSS) recruited 47 053 pregnancies, including 101 with trisomy 21, but measured free β-hCG and PAPP-A retrospectively in stored samples from 98 trisomy 21 pregnancies and 1090 matched unaffected controls 16 . Similarly, 38 167 pregnancies were recruited in the First-and SecondTrimester Evaluation of Risk (FASTER) study, including 117 with trisomy 21, and free β-hCG and PAPP-A were measured retrospectively in stored samples from 79 trisomy 21 pregnancies and 395 matched unaffected controls 17 .…”

“…The difference in PAPP-A in both previous studies was underestimated by 11% at 11 weeks and overestimated by 18% at 13 weeks 16,17 . In our study, the modeled SD of PAPP-A in unaffected pregnancies was 3-12% lower and in trisomy 21 cases it was 16-20% lower than in previous reports 16,17 . The respective values for free β-hCG in our study were lower by 4-17% in unaffected pregnancies.…”