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Related Experiment Videos

Screening for Down's syndrome using serum alpha fetoprotein: a retrospective study indicating caution.

K Spencer, P Carpenter

    British Medical Journal (Clinical Research Ed.)
    |June 29, 1985
    PubMed
    Summary

    Screening for Down's syndrome using maternal serum alpha fetoprotein (MSAFP) showed a median multiple of the median of 0.82 in affected pregnancies. Current methods are premature for reliable Down's syndrome screening.

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    Area of Science:

    • Prenatal diagnostics
    • Biochemical screening
    • Maternal health

    Background:

    • Down's syndrome screening relies on biochemical markers in maternal serum.
    • Maternal serum alpha fetoprotein (MSAFP) is a key marker in these screening programs.
    • Previous studies have reported varying efficacy of MSAFP-based screening.

    Purpose of the Study:

    • To evaluate the clinical efficiency, sensitivity, and specificity of Down's syndrome screening using MSAFP.
    • To analyze the median multiple of the median (MOM) MSAFP concentration in Down's syndrome pregnancies.
    • To assess the effectiveness of an age-related MSAFP strategy for Down's syndrome detection.

    Main Methods:

    • Retrospective study of 27,064 pregnancies over four years.
    • Analysis of maternal serum alpha fetoprotein (MSAFP) levels.

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  • Evaluation of screening performance using sensitivity and specificity metrics.

    • Main Results:

    • Identified 27 pregnancies with Down's syndrome.
    • Observed a median MOM MSAFP of 0.82 for affected pregnancies, higher than previously reported.
    • An age-related MSAFP strategy identified 30.8% of Down's affected pregnancies and 11.6% of unaffected pregnancies.

    Conclusions:

    • The observed median MOM MSAFP is significantly different from prior reports, suggesting population variance.
    • Current screening strategies based on low MSAFP concentration are deemed premature.
    • Further collaborative studies are recommended to investigate population variances in MSAFP MOM values.