1. First-trimester Down syndrome screening performance in the Dutch population; how to achieve further improvement?
- Author
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Wortelboer EJ, Koster MP, Stoutenbeek P, Elvers LH, Loeber JG, Visser GH, and Schielen PC
- Subjects
- Adolescent, Adult, Chorionic Gonadotropin, beta Subunit, Human blood, Female, Humans, Middle Aged, Netherlands, Nuchal Translucency Measurement, Pregnancy, Pregnancy-Associated Plasma Protein-A analysis, Young Adult, Down Syndrome diagnosis, Mass Screening methods, Pregnancy Trimester, First
- Abstract
Objective: To study the performance of the first-trimester combined test between 2004 and 2006 compared to a previous period to investigate changes in time and identify reasons for sub-optimal performance., Methods: Serum samples were analysed for pregnancy-associated plasma protein A (PAPP-A) and the free beta subunit of human chorionic gonadotrophin (f beta-hCG). Nuchal translucency (NT) was measured between 10 and 14 weeks. Tests were considered screen positive, if their calculated Down syndrome (DS) risk was at least 1 in 250 at term., Results: A total of 20,293 singleton pregnancies were included in the analysis. The median maternal age fell from 35.7 to 34.3 years. The overall median weight-corrected multiple of the median (MoM) values of PAPP-A and f beta-hCG were 1.12 and 1.03, respectively. The median MoM value of NT was 0.89 and increased from 0.82 to 0.96. Sixty-six DS cases were detected by the screening test. The detection rate (DR) for DS was 75.9%, with a FPR of 3.3%., Conclusion: The performance of the first-trimester test has improved over the years. A better performance of the NT measurement was the main reason, although NT assessment should further be improved. In addition, a better setting of the medians for the biochemical parameters may contribute to a higher DR., ((c) 2009 John Wiley & Sons, Ltd.)
- Published
- 2009
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