Combined screening test for trisomy 21 - is it as efficient as we believe?
| Autor: | Wioletta Rozmus-Warcholinska, Marcin Wiecheć, Ewa Wiercinska, Dominika Stettner, Jiri Sonek, Petr Plevak, Maciej Orzechowski, Agnieszka Nocun, Anna Knafel |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Pregnancy-associated plasma protein A Population Ultrasonography Prenatal 03 medical and health sciences 0302 clinical medicine Pregnancy Internal medicine medicine Humans Mass Screening Pregnancy-Associated Plasma Protein-A Chorionic Gonadotropin beta Subunit Human Prospective Studies 030212 general & internal medicine education Prospective cohort study Mass screening education.field_of_study 030219 obstetrics & reproductive medicine business.industry Absolute risk reduction Obstetrics and Gynecology medicine.disease Pregnancy Trimester First Pediatrics Perinatology and Child Health Population study Female False positive rate Down Syndrome business Trisomy Biomarkers |
| Popis: | Objectives:To compare two first-trimester screening strategies: traditional combined screening and the one based on ultrasound markers only. We investigated the effect of maternal age (MA) on the screening performance of both of these strategies.Methods:This was a prospective observational study based on a non-selected mixed-risk population of 11,653 women referred for first-trimester screening. The study population was divided in two groups: combined screening (CS) and ultrasound-based screening (US). Absolute risk was calculated to determine the influence of MA on screening performance.Results:The CS arm comprised 5145 subjects including 51 cases of trisomy 21 (T21), and the US arm comprised 5733 subjects including 87 subjects with T21. Seven hundred and seventy-five subjects were excluded from the study. For a false positive rate (FPR) of 3%, the detection rate (DR) of T21 in CS arm was 78% vs. 90% in US arm. For 5% FPR, DR was 84% and 94% in CS and US arm, respectively. MA had an influence on DR positive rates in CS: both DR and FPR for T21 increased with advance in MA.Conclusions:The US protocol showed higher DR of T21 compared to the CS one. It may be considered as a viable alternative to CS for T21 where access to biochemical testing is limited. |
| Databáze: | OpenAIRE |
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