Second trimester prenatal screening for Down's syndrome in Mainland Chinese subjects using double-marker analysis of α-fetoprotein and β-human chorionic gonadotropin combined with measurement of nuchal fold thickness.
- Author:
Fang LIU
1
;
Hongyan LIANG
;
Xiaofeng JIANG
;
Yu ZHANG
;
Li XUE
;
Chun YANG
;
Jing CHENG
;
Peijia LIU
;
Yang LIU
;
Xiaoying GUO
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Biomarkers; China; Chorionic Gonadotropin, beta Subunit, Human; blood; Down Syndrome; diagnosis; diagnostic imaging; Female; Gestational Age; Humans; Mass Screening; Nuchal Translucency Measurement; methods; Pregnancy; Pregnancy Trimester, Second; Prenatal Diagnosis; Risk Assessment; Young Adult; alpha-Fetoproteins; analysis
- From:Annals of the Academy of Medicine, Singapore 2011;40(7):315-318
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONThis study examines the effectiveness of double-marker analysis for α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) combined with measurement of nuchal fold thickness (NT) in the detection of Down's syndrome (DS) in Mainland Chinese subjects during second trimester prenatal screening.
MATERIALS AND METHODSWe examined pregnant women with a singleton pregnancy between 15 and 21 weeks of gestation who underwent second trimester screening for DS using double-marker analysis for AFP and β-hCG combined with ultrasound measurement of NT. The combined risk of DS was calculated. A cut-off of 1/270 was used to define a pregnancy at high-risk of DS. Amniocentesis was offered to all patients with high-risk pregnancies.
RESULTSUsing double-marker analysis for AFP and β-hCG in combination with measurement of NT, the detection rate of DS increased from 66.7% to 77.8% when compared with double-marker analysis alone with similar false-positive rates (4.35%, 4.83% respectively). Using receiver operating characteristic curve (ROC) analysis, we determined that the double-marker analysis combined with measurement of NT exhibited an increased area under the curve (AUC) of 0.835 (95% CI: 0.743 to 0.927) when compared to double-marker analysis alone, which had an AUC of 0.748 (95% CI: 0.635 to 0.860). In addition, both methods were more effective than any other single test such as AFP, free β-hCG or NT measurement.
CONCLUSIONSecond trimester prenatal screening using double-marker analysis for AFP and β-hCG combined with measurement of NT is effective for the detection of DS in Mainland Chinese pregnancies.
