Obstetrics & Gynecology Email Alerts
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Obstetrics & Gynecology 2000;96:207-213
© 2000 by The American College of Obstetricians and Gynecologists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by KRANTZ, D. A.
Right arrow Articles by MACRI, J. N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by KRANTZ, D. A.
Right arrow Articles by MACRI, J. N.

ORIGINAL RESEARCH

First-Trimester Down Syndrome Screening Using Dried Blood Biochemistry and Nuchal Translucency

DAVID A. KRANTZ, TERRENCE W. HALLAHAN, PhD, FRANCESCO ORLANDI, MD, PHILIP BUCHANAN, PhD, JOHN W. LARSEN, Jr, MD and JAMES N. MACRI, PhD

From the Research Division, NTD Laboratories, Huntington Station, New York; Centro Di Diagnosi Prenatale, Palermo, Italy; GeneCare Medical Genetics Center, Chapel Hill, North Carolina; and the Department of Obstetrics and Gynecology, The George Washington University Medical Center, Washington, DC.

Address reprint requests to: David A. Krantz NTD Laboratories 403 Oakwood Road Huntington Station, NY 11746

Objective: To assess the effectiveness of free ß-hCG, pregnancy-associated plasma protein A, and nuchal translucency in a prospective first-trimester prenatal screening study for Down syndrome and trisomy 18.

Methods: Risks were calculated for Down syndrome and trisomy 18 based on maternal age and biochemistry only (n = 10,251), nuchal translucency only (n = 5809), and the combination of nuchal translucency and biochemistry (n = 5809).

Results: The study population included 50 Down syndrome and 20 trisomy 18 cases. Nuchal translucency measurement was done on 33 Down syndrome and 13 trisomy 18 cases. Down syndrome screening using combined biochemistry and ultrasound resulted in a false-positive rate of 4.5% (95% confidence interval [CI] 3.9%, 5.2%) and detection rate of 87.5% (95% CI 47%, 100%) in patients under age 35 years. In older patients, the false-positive rate was 14.3% (95% CI 12.7%, 15.8%) and detection rate was 92% (95% CI 74%, 99%). For trisomy 18 screening, the false-positive rate was 0.4% (95% CI 0.24%, 0.69%) and detection rate was 100% (95% CI 40%, 100%) in younger patients, whereas in older patients the false-positive rate was 1.4% (95% CI 0.9%, 2.0%) and detection rate was 100% (95% CI 66%, 100%). Using modeling, at a fixed 5% false-positive rate, the Down syndrome detection rate was 91%. Conversely, at a fixed 70% Down syndrome detection rate, the false-positive rate was 1.4%.

Conclusion: First-trimester screening for Down syndrome and trisomy 18 is effective and offers substantial benefits to clinicians and patients.




This article has been cited by other articles:


Home page
 Hum Reprod UpdateHome page
B. Weisz and C. H. Rodeck
An update on antenatal screening for Down's syndrome and specific implications for assisted reproduction pregnancies
Hum. Reprod. Update, September 1, 2006; 12(5): 513 - 518.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
A. O. Odibo, D. M. Stamilio, D. B. Nelson, H. M. Sehdev, and G. A. Macones
A Cost-Effectiveness Analysis of Prenatal Screening Strategies for Down Syndrome
Obstet. Gynecol., September 1, 2005; 106(3): 562 - 568.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
L. D. Platt, N. Greene, A. Johnson, J. Zachary, E. Thom, D. Krantz, J. L. Simpson, R. K. Silver, R. J. M. Snijders, L. Goetzl, et al.
Sequential Pathways of Testing After First-Trimester Screening for Trisomy 21
Obstet. Gynecol., October 1, 2004; 104(4): 661 - 666.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
V. L. Souter, D. A. Nyberg, P. A. Benn, A. Zebelman, F. Luthardt, and D. A. Luthy
Correlation of Second-Trimester Sonographic and Biochemical Markers
J. Ultrasound Med., April 1, 2004; 23(4): 505 - 511.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
F. D. Malone and M. E. D'Alton
First-Trimester Sonographic Screening for Down Syndrome
Obstet. Gynecol., November 1, 2003; 102(5): 1066 - 1079.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
R. Wapner, E. Thom, J. L. Simpson, E. Pergament, R. Silver, K. Filkins, L. Platt, M. Mahoney, A. Johnson, W. A. Hogge, et al.
First-Trimester Screening for Trisomies 21 and 18
N. Engl. J. Med., October 9, 2003; 349(15): 1405 - 1413.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
P. Rozenberg, L. Malagrida, H. Cuckle, I. Durand-Zaleski, I. Nisand, F. Audibert, C. Benattar, S. Tribalat, M. Cartron, P. Lemarie, et al.
Down's syndrome screening with nuchal translucency at 12+0-14+0 weeks and maternal serum markers at 14+1-17+0 weeks: a prospective study
Hum. Reprod., April 1, 2002; 17(4): 1093 - 1098.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
Q.-P. Qin, M. Christiansen, and K. Pettersson
Point-of-Care Time-resolved Immunofluorometric Assay for Human Pregnancy-associated Plasma Protein A: Use in First-Trimester Screening for Down Syndrome
Clin. Chem., March 1, 2002; 48(3): 473 - 483.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
A.W. Liao, V. Heath, N. Kametas, K. Spencer, and K.H. Nicolaides
First-trimester screening for trisomy 21 in singleton pregnancies achieved by assisted reproduction
Hum. Reprod., July 1, 2001; 16(7): 1501 - 1504.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2000 by the American College of Obstetricians and Gynecologists.