Impact of replacing or adding placental growth factor on Down syndrome screening: A prospective cohort study
| Autor: | Kwok Ming Law, Piya Chaemsaithong, Daljit Singh Sahota, Yuen Ha Ting, Liona C. Poon, Shuk Yi Annie Hui, Tak Yeung Leung, Wing To Angela Sin, Yi Man Wah |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Placental growth factor Adult medicine.medical_specialty Singleton pregnancy Urology 030105 genetics & heredity Cohort Studies 03 medical and health sciences 0302 clinical medicine Nuchal translucency Pregnancy Prenatal Diagnosis medicine Humans Prospective Studies Prospective cohort study Genetics (clinical) Placenta Growth Factor Down syndrome screening 030219 obstetrics & reproductive medicine Obstetrics business.industry Obstetrics and Gynecology medicine.disease First trimester Cohort Combined test Hong Kong Female False positive rate Down Syndrome Trisomy business Biomarkers |
| Zdroj: | Prenatal diagnosisREFERENCES. 41(9) |
| ISSN: | 1097-0223 |
| Popis: | Objectives: To assess whether adding placental growth factor (PlGF) or replacing pregnancy-associated plasma protein-A (PAPP-A) improves the first trimester combined test performance for trisomy 21. Design: Prospective observation Cohort Setting: The Chinese University of Hong Kong, China Sample: 11,518 women having a singleton pregnancy screened for trisomy 21 between December 2016 and December 2019 using the first trimester combined test. Methods: PlGF was prospectively measured and estimated term risk for trisomy 21 was calculated by 1) replacing PAPP-A with PlGF and 2) adding PlGF to the combined test which includes nuchal translucency, PAPP-A and free β-human chorionic gonadotropin (hCG). Main Outcome Measure: Screening performance, area under curve (AUC), detection rate (DR), screen positive rate (SPR) and false positive rate (FPR) Results: 29 women had trisomy 21. The combined tests DR, FPR and SPR were 89.7%, 5.7% and 6% respectively. DR when replacing PAPP-A or adding PlGF to the combined test remained unchanged. Replacing PAPP-A by PlGF increased FPR and SPR to 6.2% and 6.4% respectively. Adding PlGF to the combined test gave FPR and SPR rates of 5.5% and 5.7% respectively. Adding or replacing PlGF did not give a significant increase in AUC (p>0.48) over that of the combined test. Conclusion: Adding PlGF to the combined test or replacing PAPP-A with PlGF in the combined test did not improve trisomy 21 detection rate. Replacing PAPP-A by PlGF increased SPR, whilst adding PlGF resulted in only a marginal reduction in SPR. |
| Databáze: | OpenAIRE |
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