Maternal Ethnicity and Variation of Fetal Femur Length Calculations When Screening for Down Syndrome

Kovac, Christine; Brown, Jennifer; Apodaca, Christina C.; Napolitano, Peter G.; Pierce, Brian; Patience, Troy; Hume, Roderick F.; Calhoun, Byron C.

doi:10.7863/jum.2002.21.7.719

Cited by 34 publications

(29 citation statements)

References 11 publications

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“…However, similar results have been found for fetuses of African ancestry in Dutch and US cohorts [22,[24][25][26]. One UK study also showed that fetuses of African ancestry had a faster growth of crown-rump length during the first-trimester, compared with Europeans [27].…”

Section: Discussionsupporting

confidence: 68%

Ethnic differences in fetal size and growth in a multi-ethnic population

Sletner

Rasmussen

Jenum

et al. 2015

Early Human Development

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Section: Discussionsupporting

confidence: 68%

Ethnic differences in fetal size and growth in a multi-ethnic population

Sletner

Rasmussen

Jenum

et al. 2015

Early Human Development

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“…Shorter femur was shown by just 1 out of the 31 of Down cases. Furthermore, previous studies report a high frequency of this marker among euploid individuals [21, 22]. In the present study, the risk increased 14-fold, with a very wide confidence interval, reflecting in low accuracy.…”

Section: Discussioncontrasting

confidence: 64%

Influence of Second-Trimester Ultrasound Markers for Down Syndrome in Pregnant Women of Advanced Maternal Age

Kataguiri

Júnior

Bussamra

et al. 2014

Journal of Pregnancy

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The objective of the present study was to evaluate the influence of second-trimester ultrasound markers on the incidence of Down syndrome among pregnant women of advanced maternal age. This was a retrospective cohort study on 889 singleton pregnancies between the 14th and 30th weeks, with maternal age ≥ 35 years, which would undergo genetic amniocentesis. The second-trimester ultrasound assessed the following markers: increased nuchal fold thickness, cardiac hyperechogenic focus, mild ventriculomegaly, choroid plexus cysts, uni- or bilateral renal pyelectasis, intestinal hyperechogenicity, single umbilical artery, short femur and humerus length, hand/foot alterations, structural fetal malformation, and congenital heart disease. To investigate differences between the groups with and without markers, nonparametric tests consisting of the chi-square test or Fisher's exact test were used. Moreover, odds ratios with their respective 95% confidence intervals were calculated. Out of the 889 pregnant women, 131 (17.3%) presented markers and 758 (82.7%) did not present markers on the second-trimester ultrasound. Increased nuchal fold (P < 0.001) and structural malformation (P < 0.001) were the markers most associated with Down syndrome. The presence of one marker increased the relative risk 10.5-fold, while the presence of two or more markers increased the risk 13.5-fold. The presence of markers on the second-trimester ultrasound, especially thickened nuchal fold and structural malformation, increased the risk of Down syndrome among pregnant women with advanced maternal age.

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“…Shortening of the fetal long bones such as the humerus and femur is a sonographic soft marker for screening of Down syndrome in the second trimester. Ethnic differences in fetal biometric measurements have been documented 1 – 3 . Beigi and ZarrinKoub 3 reported that Iranian fetuses had a shorter femur length in comparison with western studies.…”

mentioning

confidence: 99%

“…Beigi and ZarrinKoub 3 reported that Iranian fetuses had a shorter femur length in comparison with western studies. Kovac et al 1 concluded that Asian groups had a less‐than‐expected femur length.…”

mentioning

confidence: 99%

Normal Ranges for Fetal Femur and Humerus Diaphysis Length During the Second Trimester in an Iranian Population

Tahmasebpour¹,

Pirjani²,

Rahimiforoushani³

et al. 2012

Journal of Ultrasound in Medicine

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onographic markers are widely used for aneuploidy screening. Shortening of the fetal long bones such as the humerus and femur is a sonographic soft marker for screening of Down syndrome in the second trimester. Ethnic differences in fetal biometric measurements have been documented. [1][2][3] Beigi and ZarrinKoub 3 reported that Iranian fetuses had a shorter femur length in comparison with western studies. Kovac et al 1 concluded that Asian groups had a less-than-expected femur length.Undoubtedly, ethnic differences in fetal femur and humerus diaphysis length would have a considerable impact on Down syndrome screening; in one study, positive sonographic results were reported more frequently in nonwhite ethnicities because of shorter long bones. 2 In our previous study, we obtained normal ranges for the fetal nasal bone during the second trimester of pregnancy. 4 The aim of this study was to provide normal ranges for femur and humerus diaphysis length during the second trimester in an Iranian population. -Reza Tahmasebpour, MD, Reihaneh Pirjani, MD, Abbas Rahimi-Foroushani, PhD, Saeed Reza Ghaffari, MD, Fatemeh Rahimi-Sharbaf, MD, Farzaneh Fattahi Masrour, MD Received November 18, 2011, from the Iranian Fetal Medicine Foundation, Tehran, Iran (A.-R.T., S.R.G., F.F.M.) Ahmad ORIGINAL RESEARCHObjectives-Shortening of the fetal long bones is a sonographic soft marker for screening of Down syndrome in the second trimester that can be influenced by ethnicity. The purpose of this study was to provide normal reference ranges for femur and humerus diaphysis length during the second trimester of pregnancy in an Iranian population.Methods-This cross-sectional study was performed on 3011 singleton fetuses at 15 to 28 weeks' menstrual age. The relationship between menstrual age and both femur and humerus diaphysis length was determined, and percentile values for each menstrual week were provided.Results-The median femur diaphysis length ranged from 18.05 mm at 15 menstrual weeks to 52.20 mm at 28 menstrual weeks, and the mean humerus diaphysis length ranged from 17.65 mm at 15 menstrual weeks to 48.10 mm at 28 menstrual weeks. There was a linear relationship between menstrual age and both femur diaphysis length (R 2 = 0.957) and humerus diaphysis length (R 2 = 0.941).Conclusions-We have provided normal reference ranges for femur and humerus diaphysis length during the second trimester of pregnancy in an Iranian population.

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Maternal Ethnicity and Variation of Fetal Femur Length Calculations When Screening for Down Syndrome

Cited by 34 publications

References 11 publications

Ethnic differences in fetal size and growth in a multi-ethnic population

Ethnic differences in fetal size and growth in a multi-ethnic population

Influence of Second-Trimester Ultrasound Markers for Down Syndrome in Pregnant Women of Advanced Maternal Age

Normal Ranges for Fetal Femur and Humerus Diaphysis Length During the Second Trimester in an Iranian Population

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