Invasive Trophoblast Antigen (Hyperglycosylated Human Chorionic Gonadotropin) in Second-Trimester Maternal Urine as a Marker for Down Syndrome: Preliminary Results of an Observational Study on Fresh Samples
| Autor: | Charles M. Strom, George C. Cunningham, Glenn E. Palomaki, George J. Knight, Marie Roberson, Raj Pandian, Jo Ellen Lee |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
medicine.medical_specialty Down syndrome Pregnancy High-Risk Clinical Biochemistry Urine Biology Chorionic Gonadotropin Human chorionic gonadotropin Pregnancy medicine Humans False Positive Reactions Gynecology medicine.diagnostic_test Biochemistry (medical) Triple test Gestational age medicine.disease Trophoblasts Pregnancy Trimester Second Amniocentesis Female Down Syndrome Trisomy Biomarkers Maternal Age |
| Zdroj: | Clinical Chemistry. 50:182-189 |
| ISSN: | 1530-8561 0009-9147 |
| Popis: | Background: Down syndrome screening is commonly performed in the US using maternal age and three or four second-trimester maternal serum markers that can identify up to 75% of affected pregnancies by offering diagnostic studies to 5% of women. Invasive trophoblast antigen [ITA; hyperglycosylated human chorionic gonadotropin (hCG)] is a promising marker that can be measured in urine or serum in the first or second trimester. We report preliminary results for urinary ITA in an ongoing observational study.Methods: Women undergoing second-trimester amniocentesis for reasons not associated with biochemical testing provided consent and a urine (and possibly serum) sample that was tested within a few days. Demographic and pregnancy-related information was collected, along with karyotype. Screening performance was modeled for ITA alone and in combination with serum markersResults: Twelve recruitment centers collected urine from 2055 women with singleton pregnancies between 15 and 20 weeks of gestation (2023 unaffected, 28 Down syndrome, and 4 pregnancies with other chromosome abnormalities). After correction for gestational age, urine concentration, and maternal race and weight, the ITA measurements were higher in women with a Down syndrome pregnancy (median ITA, 4.33 multiples of the median). At a 75% detection rate, the false-positive rate could be reduced by substituting ITA for hCG measurements (from 5.6% to 2.6% for the triple test) or by adding ITA measurements to existing combinations (from 3.3% to 2.0% for the quadruple test).Conclusions: Our data provide preliminary confirmation of the potential usefulness of urinary ITA measurements in detecting Down syndrome in a setting that simulates routine usage. |
| Databáze: | OpenAIRE |
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