First and second trimester maternal serum markers for prenatal aneuploidy screening: An update on the adjustment factors for race, smoking, and insulin dependent diabetes mellitus.

Autor: Huang T; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; Genetics Program, North York General Hospital, Toronto, Ontario, Canada; Department of Obstetrics & Gynaecology, University of Toronto, Toronto, Ontario, Canada. Electronic address: tianhua.huang@nygh.on.ca., Bellai-Dussault K; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada., Meng L; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada., Hull D; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada., Howley H; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada., Reszel J; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada., Lanes A; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada., Walker M; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada; Department of Obstetrics, Gynecology & Newborn Care, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada., Armour CM; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada., Okun N; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; Department of Obstetrics & Gynaecology, University of Toronto, Toronto, Ontario, Canada; Maternal Fetal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada., Dougan SD; Prenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada.
Jazyk: angličtina
Zdroj: Clinical biochemistry [Clin Biochem] 2023 Aug; Vol. 118, pp. 110596. Date of Electronic Publication: 2023 Jun 08.
DOI: 10.1016/j.clinbiochem.2023.110596
Abstrakt: Objectives: The concentrations of maternal serum markers for aneuploidy screening are influenced by maternal characteristics such as race, smoking, insulin dependent diabetes mellitus (IDDM), and in vitro fertilization (IVF). Accurate risk estimation requires adjustment of initial values for these characteristics. This study aims to update and validate adjustment factors for race, smoking, and IDDM.
Methods: The study included singleton pregnancies that received multiple marker screening in Ontario, Canada between January 2012, and December 2018, and had their information collected in the Better Outcomes Registry & Network (BORN) Ontario. Serum markers assessed included first trimester pregnancy-associated plasma protein A (PAPP-A), free β and total human chorionic gonadotropin (hCG), placental growth factor (PlGF) and αlpha-fetoprotein (AFP); second trimester AFP, unconjugated estriol (uE3), total hCG and inhibin A. The Mann-Whitney U test was used to assess the differences in the median multiple of the median (MoM) of serum markers between study and reference groups. New adjustment factors were generated by dividing the median MoM of a particular race, individuals who smoke tobacco, or have IDDM by those of the reference groups.
Results: The study included 624,789 pregnancies. There were statistically significant differences in serum marker concentrations among pregnant individuals who were Black, Asian, or First Nations compared to a White group, those who smoked compared to Non-smoking individuals, and those with IDDM compared to Non-IDDM group. New adjustment factors for race, smoking, and IDDM were validated by comparing median MoM of serum markers corrected using the current adjustment factors and new adjustment factors generated in this study.
Conclusion: The adjustment factors generated in this study can adjust the effects of race, smoking, and IDDM on serum markers more accurately.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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