Literature DB >> 16049986

Maternal weight and ethnic adjustment within a first-trimester Down syndrome and trisomy 18 screening program.

David A Krantz1, Terrence W Hallahan, V James Macri, James N Macri.   

Abstract

OBJECTIVE(S): To estimate weight and ethnic group correction factors for first-trimester screening markers.
METHODS: Ethnic-specific median MoM free beta hCG and pregnancy associated plasma protein A (PAPP-A) and delta nuchal translucency values were calculated for cohorts of maternal weight (20 lb each) using data from 51,206 patients undergoing first-trimester screening. False-positive rates for Down syndrome and trisomy 18 were evaluated both prior to and after weight and ethnicity adjustment.
RESULTS: Free beta hCG and PAPP-A significantly decreased with increasing maternal weight while nuchal translucency increased by a clinically insignificant amount. For free beta hCG the regression formula indicated that after accounting for maternal weight MoM values were 16% higher for African Americans, 6% higher for Asians and 9% lower for Hispanics compared to Caucasians (p < 0.001, p = 0.001, p < 0.001, respectively) but there was no significant difference for Asian Indians. For PAPP-A, MoM values were 35% higher for African Americans (p < 0.001) but were not significantly different for the other ethnic groups compared to Caucasians. Down syndrome false-positive rates did not vary with maternal weight prior to (p = 0.291) or after weight adjustment of biochemistry (p = 0.054). Trisomy 18 false-positive rates varied significantly with weight both before (OR = 1.455 per 20-pound increase, p < 0.001) and after (OR = 1.066 per 20-pound increase, p = 0.01) weight adjustment of biochemistry; however, the odds ratio was greatly reduced after weight adjustment. CONCLUSION(S): The first-trimester screening markers, free beta hCG, PAPP-A and nuchal translucency vary with maternal weight and ethnicity. Adjustment of free beta hCG and PAPP-A is indicated but adjustment of nuchal translucency results may not be necessary. Copyright 2005 John Wiley & Sons, Ltd.

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Year:  2005        PMID: 16049986     DOI: 10.1002/pd.1188

Source DB:  PubMed          Journal:  Prenat Diagn        ISSN: 0197-3851            Impact factor:   3.050


  9 in total

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Authors:  S Kate Alldred; Yemisi Takwoingi; Boliang Guo; Mary Pennant; Jonathan J Deeks; James P Neilson; Zarko Alfirevic
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Review 2.  First and second trimester serum tests with and without first trimester ultrasound tests for Down's syndrome screening.

Authors:  S Kate Alldred; Yemisi Takwoingi; Boliang Guo; Mary Pennant; Jonathan J Deeks; James P Neilson; Zarko Alfirevic
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Review 4.  Second trimester serum tests for Down's Syndrome screening.

Authors:  S Kate Alldred; Jonathan J Deeks; Boliang Guo; James P Neilson; Zarko Alfirevic
Journal:  Cochrane Database Syst Rev       Date:  2012-06-13

5.  How and when human chorionic gonadotropin curves in women with an ectopic pregnancy mimic other outcomes: differences by race and ethnicity.

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Review 6.  First trimester serum tests for Down's syndrome screening.

Authors:  S Kate Alldred; Yemisi Takwoingi; Boliang Guo; Mary Pennant; Jonathan J Deeks; James P Neilson; Zarko Alfirevic
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Review 7.  Urine tests for Down's syndrome screening.

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Review 8.  Limitations of Aneuploidy and Anomaly Detection in the Obese Patient.

Authors:  Paula Zozzaro-Smith; Lisa M Gray; Stephen J Bacak; Loralei L Thornburg
Journal:  J Clin Med       Date:  2014-07-17       Impact factor: 4.241

9.  First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes Mellitus.

Authors:  Padmalatha Gurram; Peter Benn; James Grady; Anne-Marie Prabulos; Winston Campbell
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  9 in total

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