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[Localization of gestational age reference table and its application in prenatal screening].
Linlin Dou1, Guohui Yang1, Weiming Mo1
1Prenatal Screening Center, Zhejiang Xiaoshan Hospital, Hangzhou 311201, China.
Summary
Developing a localized fetal biparietal diameter (BPD)-gestational age formula improved prenatal screening accuracy. This localized formula reduced false positives for Down syndrome and neural tube defects, enhancing reliability in expectant mothers.
Area of Science:
- Maternal-fetal medicine
- Prenatal diagnostics
- Biometry
Background:
- Accurate gestational age estimation is crucial for effective prenatal screening.
- Existing biparietal diameter (BPD)-gestational age formulas may not be universally applicable due to population variations.
- Localized formulas can potentially improve the precision of prenatal risk assessment.
Purpose of the Study:
- To establish a localized fetal BPD-gestational age formula using data from pregnant women in Xiaoshan District, Hangzhou.
- To evaluate the efficacy of this localized formula in prenatal screening, particularly for women with uncertain menstrual history.
- To compare the performance of the localized formula against a standard formula (LifeCycle 4.0).
Main Methods:
- Collected BPD data from 3500 pregnant women (15-19 weeks+6 days gestation) for formula development.
- Applied the localized formula to 1759 pregnant women with irregular or uncertain menstrual cycles for risk assessment.
- Compared screening results, including positive rates and median multiples of median (MoMs) for biochemical markers, with the LifeCycle 4.0 formula.
Main Results:
- The localized BPD-gestational age formula significantly reduced the overall positive screening rate from 6.96% to 5.85% (P<0.05).
- Specific reductions were observed in positive rates for Down syndrome (P<0.05) and an increase for neural tube defects (P<0.05).
- Median MoMs for free-hCG β and α-fetoprotein were closer to 1 when using the localized formula, indicating improved accuracy.
Conclusions:
- Localized BPD-gestational age formulas, derived from regional population data, are essential for optimizing prenatal screening.
- Implementing localized formulas can decrease false positive rates, leading to more accurate and reliable prenatal diagnostic outcomes.
- This approach enhances the precision of risk assessment for fetal aneuploidies and structural abnormalities.
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