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Related Experiment Videos

Co-variables in first trimester maternal serum screening.

I M de Graaf1, H S Cuckle, E Pajkrt

  • 1Department of Obstetrics and Gynaecology, Department of Clinical Genetics, Academic Medical Centre, Amsterdam, The Netherlands. I.M.deGraaf@AMC.UvA.NL

Prenatal Diagnosis
|March 17, 2000
PubMed
Summary

Maternal weight, smoking, gravidity, parity, and fetal gender significantly influence first-trimester screening markers for Down syndrome. Adjusting for these factors improves the accuracy of Down syndrome screening tests.

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Area of Science:

  • Maternal-Fetal Medicine
  • Prenatal Diagnostics
  • Biochemistry

Background:

  • First-trimester screening for Down syndrome relies on maternal serum markers.
  • Accurate interpretation of these markers is crucial for effective prenatal diagnostics.
  • Factors like maternal characteristics can influence marker levels, potentially affecting screening accuracy.

Purpose of the Study:

  • To investigate the impact of maternal weight, smoking, gravidity, parity, and fetal gender on serum markers used in first-trimester Down syndrome screening.
  • To identify key co-variables that necessitate adjustment in Down syndrome screening protocols.

Main Methods:

  • Analysis of 2449 unaffected singleton pregnancies.
  • Measurement of maternal serum free beta-human chorionic gonadotrophin (hCG), alpha-fetoprotein (AFP), and pregnancy-associated plasma protein-A (PAPP-A).

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  • Expression of marker levels as multiples of the median (MoM) and adjustment for maternal weight and other covariates.

    • Main Results:

    • Maternal weight showed a significant negative association with all three markers (PAPP-A, free beta-hCG, AFP).
    • Maternal smoking significantly reduced PAPP-A levels (median 0.81 MoM) and non-significantly reduced free beta-hCG.
    • Primagravidas had significantly higher AFP levels, while female fetuses were associated with higher free beta-hCG and lower AFP levels.

    Conclusions:

    • Maternal weight and smoking are critical co-variables for PAPP-A in first-trimester screening.
    • Gravidity, parity, and fetal gender also demonstrate influence on one or more first-trimester screening markers.
    • Adjusting for these factors is essential for optimizing the accuracy of Down syndrome screening.