The impact of fetal gender on first trimester nuchal translucency and maternal serum free β‐hCG and PAPP‐A MoM in normal and trisomy 21 pregnancies

Cowans, Nicholas J.; Stamatopoulou, Anastasia; Maíz, Nerea; Spencer, Kevin; Nicolaides, Kypros H.

doi:10.1002/pd.2246

Cited by 36 publications

(41 citation statements)

References 34 publications

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“…In addition, Timmerman et al [9] found that male fetuses with a large NT have a greater chance of a favorable outcome than females. Cowans et al [10] investigated the impact of correcting first trimester screening for fetal sex and found a detection rate of 88.8% in male fetuses compared to 91.2% in female fetuses (not statistically different). When the group adjusted for fetal sex, they found almost identical screen positive rates for a detection rate of 89.7% in male fetuses compared to 90.2% in females.…”

Section: Discussionmentioning

confidence: 99%

“…slightly increasing the detection rate for an unchanged false-positive rate). At present, it is recommended to adjust for smoking status [1] , and adjustment for fetal sex has been suggested to be worth considering [10] , but further studies are needed, including cost-benefit analyses. At present, more results are needed on the effect of obesity on NT before adjustments in screening can be considered.…”

Section: Discussionmentioning

confidence: 99%

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Maternal Smoking, Obesity and Male Fetal Sex Predispose to a Large Nuchal Translucency Thickness in Healthy Fetuses

et al. 2010

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Objectives: Our aim was to evaluate the effect of fetal sex, smoking and body mass index (BMI) on nuchal translucency (NT). Methods: We analyzed data from 7,357 women with a normal singleton live birth outcome with information on smoking, BMI and sex of the infant. NT measurements were converted to multiples of the median (MoM_NT) using a previously reported linear regression analysis. Results: The odds ratio (OR) for MoM_NT >95th centile was 1.5 (95% CI 1.2–1.9) for smokers compared to nonsmokers and 1.4 (95% CI 1.1–1.7) for male fetuses compared to female fetuses. Obese women (BMI ≧30) had an increased OR for a large NT of 1.7 (95% CI 1.2–2.6) compared to normal weight women. Obese smokers carrying a male fetus had an OR of 4.2 (95% CI 1.7–10.1) of a MoM_NT >95th centile compared to normal weight nonsmoking women with a female fetus. The effects of smoking, obesity status and fetal sex were independent of each other. Conclusions: Smoking, obesity and male sex are associated to a MoM_NT >95th centile. This may affect screening performance and entail unnecessary anxiety in these women. Further investigations, including fetuses with adverse outcome, are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Maternal Smoking, Obesity and Male Fetal Sex Predispose to a Large Nuchal Translucency Thickness in Healthy Fetuses

et al. 2010

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“…Cowans et al 1 demonstrated the significant influence of fetal gender on values of nuchal translucency (delta NT) and level of free ß-hCG and PAPP-A in maternal serum during screening for chromosomal aneuploidies in the first trimester on a set of 56024 normal singleton pregnancies and in 722 pregnancies where the fetus had trisomy 21. Normal female fetuses had levels of nuchal translucency (delta NT) which were 9.4% lower, and maternal serum levels of free ß-hCG and PAPP-A were higher (by 14.7% and 6.3% respectively) compared to fetuses of male gender.…”

Section: Discussionmentioning

confidence: 99%

“…During screening for Down syndrome in the I. trimester of pregnancy, parameters with values dependent on fetal gender (fetal nuchal translucency measured by ultrasound, free β-hCG and PAPP-A levels in maternal serum) are evaluated when calculating "individual risk" of incidence of trisomy in the fetus [1][2][3][4] . Reliable non-invasive determination of fetal gender in the monitored time period could enable modification of normal values of these parameters based on fetal gender and make the algorithm for calculating "individual risk" more accurate.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound evaluation of fetal gender at 12-14 weeks

Ľubušký¹,

Studničková²,

Skřivánek³

et al. 2012

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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, Martin Prochazka aAims. The aim of this study was to assess the feasibility and accuracy of fetal gender assignment by transabdominal ultrasound at 12-14 weeks of gestation. Methods. Fetal gender assessment was performed in 1222 singleton pregnancies. In all fetuses the crown-rump length (CRL) was measured and the genital area of the fetus was examined in the mid-sagittal plane. The result of ultrasound examination was compared to the phenotypic sex of the newborn after delivery. Results. The feasibility as well as accuracy in determining gender increased with growing fetal CRL. At CRL < 50 mm (gestational age < 11+4) the feasibility was 39.1% and accuracy 30.5% (40.9% in male gender vs 24.3% in female gender). At CRL 50-54.9 mm (gestational age 11+4 to 12+0) the feasibility was 63.5% and accuracy 75.0% (89.1% in male gender vs 66.7% in female gender). At CRL 55-59.9 mm (gestational age 12+0 to 12+2) the feasibility was 90.5% and accuracy 96.6% (99.1% in male gender vs 93.5% in female gender). At CRL ≥ 60 mm (gestational age ≥ 12+2) the feasibility was 97.4% and accuracy 100.0% (100.0% in male gender vs 100.0% in female gender). Conclusions. Fetal gender may reliably be determined when CRL ≥ 60 mm (gestational age ≥ 12+2). Male gender may already be reliably determined when CRL ≥ 55 mm (gestational age ≥ 12+0). If CRL < 50 mm (gestational age < 11+4) the gender cannot be reliably predicted.

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“…Catalano et al (2012) reasoned that if the shifting distribution explanation were correct, indicators of fitness among male fetuses that survive to birth would fall below expected levels in conception cohorts that yield fewer than expected male infants (i.e., live male births). Based on previous research (Cole, 2010;Cowans et al, 2009;Dugoff et al, 2004;Goetzl et al, 2004;Jelliffe-Pawlowski et al, 2010;Kirkegaard et al, 2010;Sasaki et al, 2008;Yaron et al, 2001), they used the median male hCG score, measured in the second trimester of gestation, as an indicator of fitness among survivors of 71 monthly California conception cohorts. Because of autocorrelation in both series, they performed the analysis not on the raw hCG medians and sex ratios, but on residuals derived from a Box-Jenkins ARIMA model (Box et al, 1994).…”

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confidence: 99%

Hormonal evidence of selection in utero revisited

Catalano

Currier

Steinsaltz

2014

American J Hum Biol

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Objectives: Human conception cohorts in gestation during stressful times reportedly yield lower ratios of male to female live births than do other conception cohorts. Much literature attributes this phenomenon to spontaneous abortion of less fit male fetuses. Controversy remains, however, as to whether stressful times make males fetuses less fit ("Shifting Distribution" of fitness) or whether male fetuses need greater fitness to avoid spontaneous abortion during stressful times ("Shifting Criterion" for survival).Methods: Although research using gestational hCG as a signal of fetal fitness reports support for the latter mechanism, we believe an analytic error casts doubt on those findings. Here we offered an alternative test that corrects the error.Conclusion: This more accurate test found similar results to those originally reported. Am. J. Hum. Biol. 27:426-431, 2015.

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The impact of fetal gender on first trimester nuchal translucency and maternal serum free β‐hCG and PAPP‐A MoM in normal and trisomy 21 pregnancies

Cited by 36 publications

References 34 publications

Maternal Smoking, Obesity and Male Fetal Sex Predispose to a Large Nuchal Translucency Thickness in Healthy Fetuses

Maternal Smoking, Obesity and Male Fetal Sex Predispose to a Large Nuchal Translucency Thickness in Healthy Fetuses

Ultrasound evaluation of fetal gender at 12-14 weeks

Hormonal evidence of selection in utero revisited

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