FIRST-TRIMESTER BIOCHEMICAL SCREENING FOR DOWN SYNDROME WITH THE USE OF PAPP-A, AFP, AND β-hCG

Casals, Elena; Fortuny, Albert; Grudzinskas, J. G.; Suzuki, Yoshichika; Teisner, B.; Comas, C.; Sanllehy, C; Ojuel, Júlia; Borrell, Antoni; Soler, Anna; Ballesta, Antonio M.

doi:10.1002/(sici)1097-0223(199605)16:5<405::aid-pd868>3.0.co;2-y

Cited by 17 publications

(8 citation statements)

References 32 publications

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“…We extended a previous meta-analysis of first-trimester PAPP-A and free -hCG (van Lith, 1996) and another for AFP and uE 3 (van Lith, 1997). These overviews, which used the same search strategy as adopted here, were brought up to date to include nine further first-trimester series (Scott et al, 1996;Krantz et al, 1996;Casals et al, 1996;Spencer et al, 1997;Berry et al, 1997;Haddow et al, 1998;Wheeler and Sinosich, 1998;Tsukerman et al, 1999;de Graaf et al, 1999) and a recent extended version of a previous series (Forest et al, 1997). For first-trimester PAPP-A, individual MOM values could be extracted from 12 of the series, including five from a pooled analysis (Cuckle, 1994) and one where a subset of results had been published separately (Hurley et al, 1993).…”

Section: Sources Of Informationmentioning

confidence: 99%

Appropriate biochemical parameters in first-trimester screening for Down syndrome

1999

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Meta‐analysis was used to calculate maternal serum marker distribution parameters for Down syndrome risk estimation in the first trimester. Data from 44 series were combined: relating to pregnancy associated plasma protein (PAPP)‐A in 18, free β human chorionic gonadotrophin (hCG) in 17, α‐fetoprotein (AFP) in 26 and unconjugated oestriol (uE3) in 9. All levels were expressed in multiples of the normal median (MOM) for gestational age. Individual PAPP‐A levels were available for 439 first and second‐trimester Down syndrome pregnancies. The median MOM value increased with gestation: 0.35 at 6–8 weeks (31 cases), 0.40 at 9–11 weeks (197), 0.62 at 12–14 weeks (113) and 0.94 thereafter (98). A cubic regression equation was fitted so it could be estimated for each week of gestation. For the other markers the median value in Down syndrome was estimated from the weighted mean across all first‐trimester series: 1.98 MOM for free β‐hCG in 579 cases; 0.79 MOM for AFP in 243 and 0.74 MOM for uE3 in 226. Variance–covariance matrices were calculated directly in unaffected pregnancies and from the difference between affected and unaffected pregnancies in Down syndrome. Based on these parameters we estimate that screening at 9–11 weeks with PAPP‐A and free β‐hCG will yield a 64.6 per cent detection rate for a 5 per cent false‐positive rate. Adding a third marker will increase detection to 66.6 per cent for AFP and 68.6 per cent for uE3; using all four markers it increases to 70.1 per cent. Routine ultrasound nuchal translucency measurement in addition to serum testing will increase the rates to 86.4 per cent, 87.2 per cent, 87.9 per cent and 88.3 per cent, respectively. Copyright © 1999 John Wiley & Sons, Ltd.

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Section: Sources Of Informationmentioning

confidence: 99%

Appropriate biochemical parameters in first-trimester screening for Down syndrome

1999

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“…The first intimation that the Down's syndrome median for PAPP-A was not constant across gestation came from Bersinger et al (1994) where it was shown that the median MoM at 10-11 weeks in 20 cases was 0·47 and at 12-13 weeks in 9 cases it was 0·85. Other studies of PAPP-A in the first trimester Casals et al, 1996;Wald et al, 1996;Berry et al, 1997;Krantz et al, 1998) have also shown the progressive change in median MoM through gestation, either numerically or visually in figures. In early gestation, the true population mean will be significantly lower whilst later in gestation it will be significantly higher.…”

Section: Crl=75 MMmentioning

confidence: 83%

Letter. Response to: Wald, N.J. and Hackshaw, A.K. (1997). Combining ultrasound and biochemistry in first‐trimester screening for Down's syndrome, Prenat. Diagn. , 17 , 821–829

et al. 1998

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“…Antenatal screening for fetal Down syndrome was introduced in the 1960s among older pregnant women, and was gradually integrated in general practice as several maternal serum markers were found to be associated with fetal Down syndrome [4–7]. Multiple marker protocols were then developed to screen for Down syndrome [8–11].…”

Section: Discussionmentioning

confidence: 99%

Chinese weight‐correction model for maternal serum markers in Down syndrome prenatal screening

Wang

Zhang

Peng

et al. 2007

Intl J Gynecology & Obste

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FIRST-TRIMESTER BIOCHEMICAL SCREENING FOR DOWN SYNDROME WITH THE USE OF PAPP-A, AFP, AND β-hCG

Cited by 17 publications

References 32 publications

Appropriate biochemical parameters in first-trimester screening for Down syndrome

Appropriate biochemical parameters in first-trimester screening for Down syndrome

Letter. Response to: Wald, N.J. and Hackshaw, A.K. (1997). Combining ultrasound and biochemistry in first‐trimester screening for Down's syndrome, Prenat. Diagn. , 17 , 821–829

Chinese weight‐correction model for maternal serum markers in Down syndrome prenatal screening

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