Screening for Down’s Syndrome and Neural Tube Defect in Croatia

Brajenović-Milić, Bojana; Tišlarić, Dubravka; Bačić, Josip; Paravić, Jadranka; Slivar, A; Kapović, Miljenko; Košec, Vesna; Ristić, Smiljana; Rajhvajn, B

doi:10.1159/000020871

Cited by 7 publications

(4 citation statements)

References 20 publications

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“…Both kits were produced by CIS Bio International (Gyf-sur-Yvette, France) and incorporated FBT11 as monoclonal antibody for ß-subunit. The concentrations of measured analytes were converted to multiples of median (MoM) for unaffected pregnancies of the corresponding gestational age, previously established for our own population of pregnant women [18]. The gestational age was determined mainly by ultrasound (96%) and, in the remaining women, by the date of the last menstrual period.…”

Section: Methodsmentioning

confidence: 99%

The Influence of Smoking and Parity on Serum Markers for Down’s Syndrome Screening

et al. 2002

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Objective: To evaluate the impact of smoking and number of previous births on maternal serum levels of α-fetoprotein and free β-subunit of human chorionic gonadotropin (free β-hCG). Methods: The study included 3,252 completed unaffected singleton pregnancies that proceeded beyond 37 weeks’ gestation and resulted with a birth of healthy child. Smoking status of mothers and data concerning gravidity and parity were collected at the sampling date. Serum markers were measured between 13 and 22 gestational weeks, corrected for maternal weight, and converted to multiples of median (MoM) for unaffected pregnancy of the corresponding gestational age. Median MoM values for both markers were examined in relation to both: smoking habits and number of previous births. Results: Smokers had significantly decreased free β-hCG MoM values compared to nonsmokers (p < 0.001). The median levels showed a negative relationship with the number of previous births. The significance of a decreasing trend was proved, both in smokers (p < 0.001) and nonsmokers (p < 0.001). The median maternal serum α-fetoprotein MoM values did not show any significant dependence, neither with regard to smoking (p = 0.65) nor with regard to parity (p = 0.07). Conclusions: The recommendable adjustment of serum markers to smoking habits, especially concerning the free β-hCG levels, would be worthwhile. The evidence of the coexisting influence of parity on serum levels of free β-hCG, both in smokers and nonsmokers, should perhaps be a stimulus for reconsideration of which corrections the screening performance is dependent on.

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Section: Methodsmentioning

confidence: 99%

The Influence of Smoking and Parity on Serum Markers for Down’s Syndrome Screening

et al. 2002

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“…Screening tests are optional and can be accessed in the public or private sector. Since 1996, second trimester maternal serum screening (MSS) for DS has been offered as a part of routine prenatal care in Rijeka, Croatia (Brajenović-Milić et al 1998). Although women receive the information about the purpose and features of the test from their gynecologists, when the pregnancy is confirmed by ultrasound (8-10 weeks of gestation) this approach was previously found to be insufficient for informed consent (Paravić et al 1999), so a consultation provided by specially trained staff midwives has become obligatory before testing.…”

Section: Introductionmentioning

confidence: 99%

Men's Knowledge About Maternal Serum Screening for Down Syndrome and their Attitude Towards Amniocentesis

Brajenović-Milić

Dorčić

2016

Journal of Genetic Counseling

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The present study aimed to assess (i) the impact of screening consultation on male partner's knowledge about second trimester maternal serum screening for Down syndrome and on their attitudes toward amniocentesis, and (ii) the concomitant effect of men's involvement in pregnancy on both knowledge and attitudes. The study included 164 men who accompanied their partners to the screening appointment. Knowledge Questionnaire and Partner's Involvement in Pregnancy Scale with two dimensions, support and distance, were administered. Involvement in pregnancy was determined using two factors; support and distance. Findings revealed a significant post-consultation improvement in men's knowledge about the test, but less-educated men and those who were more distanced from partner and pregnancy were less knowledgeable even post-consultation. Compared to before the consultation, most men had a positive attitude toward amniocentesis and were willing to suggest it to their partners in case of positive test results (77 % and 42 %, respectively). The remainder would either leave the decision to their partners (20 %) or were undecided (3 %). Higher perception of distance was associated with men's unwillingness to be involved in amniocentesis decisions, particularly before consultation. However, the consultation had considerable potential to engage men with this attitude in the decision-making process. The study highlights the need to change woman-oriented prenatal screening practices for Down syndrome to involve their male partners in the consultation.

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“…The screening protocol, assay methods, risk calculation and detection rates have been described previously [12]. All the relevant information on pregnancy progress and outcome for the women who participated in screening program were abstracted from obstetric and delivery room databases as well as from postpartum child health records.…”

Section: Methodsmentioning

confidence: 99%

Elevated Second-Trimester Free β-hCG as an Isolated Finding and Pregnancy Outcomes

Brajenović-Milić

Tišlarić²,

Žuvić-Butorac³

et al. 2004

Fetal Diagn Ther

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Objective: To investigate the relationship between unexplained elevated second-trimester free β-human chorionic gonadotropin (β-hCG) levels and pregnancy complications as well as adverse pregnancy outcomes. Methods: The study cohort comprised 2,110 non-smoking women with chromosomal and structurally normal fetuses at low-risk for both Down’s syndrome (risk <1:250) and neural tube defects (maternal serum α-fetoprotein <2.0 MoM). A free β-hCG value of ≧2.0 MoM was used to define the populations with elevated levels of free β-hCG. Descriptive statistics, χ² test, Fisher’s exact test, and logistic regression analysis were used for statistical analysis, and p < 0.05 was considered statistically significant. Results: The mean maternal age of the study group was significantly lower than in controls (27.9 ± 4.3 and 30.6 ± 5.1 years, respectively, p < 0.05), while the proportion of primigravidas was significantly higher compared to that of controls (p < 0.05). After adjustment of the 2 groups according to maternal age and parity, we observed an increased incidence of preeclampsia among women with elevated free β-hCG levels in relation to controls (p < 0.05). However, a logistic regression analysis demonstrated that the free β-hCG level was not a predictor of the occurrence of preeclampsia. No significant relationship was found with the incidence of gestational diabetes, oligohydramnios, polyhydramnios, pregnancy-related hypertension, intrauterine growth retardation, preterm delivery, spontaneous abortion and stillbirths (p > 0.05).

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Screening for Down’s Syndrome and Neural Tube Defect in Croatia

Cited by 7 publications

References 20 publications

The Influence of Smoking and Parity on Serum Markers for Down’s Syndrome Screening

The Influence of Smoking and Parity on Serum Markers for Down’s Syndrome Screening

Men's Knowledge About Maternal Serum Screening for Down Syndrome and their Attitude Towards Amniocentesis

Elevated Second-Trimester Free β-hCG as an Isolated Finding and Pregnancy Outcomes

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