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Related Experiment Videos

Second-trimester dimeric inhibin-A in Down's syndrome screening

K Spencer1, E M Wallace, S Ritoe

  • 1Clinical Biochemistry Department, Oldchurch Hospital, Romford, Essex, U.K.

Prenatal Diagnosis
|December 1, 1996
PubMed
Summary

Dimeric inhibin-A levels are elevated in pregnancies affected by Down syndrome, showing potential as a screening marker. This marker is particularly effective earlier in gestation for improved detection rates.

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Area of Science:

  • Biochemistry
  • Genetics
  • Maternal-Fetal Medicine

Background:

  • Previous studies indicated elevated immunoreactive inhibin in Down syndrome pregnancies.
  • Non-specific assays detected various inhibin forms, limiting diagnostic precision.
  • Recent advancements introduced specific assays for dimeric inhibin-A.

Purpose of the Study:

  • To evaluate dimeric inhibin-A as a potential second-trimester screening marker for Down syndrome.
  • To establish normative data for dimeric inhibin-A levels in relation to gestational age.
  • To assess the performance of dimeric inhibin-A in combination with other markers.

Main Methods:

  • Analysis of maternal serum samples from 157 Down syndrome cases and 367 unaffected controls.
  • Gestational age range: 14-20 weeks.

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  • Statistical analysis including median Multiples of the Median (MOM) and mathematical modeling for detection rates.

    • Main Results:

    • Median MOM for dimeric inhibin-A was significantly higher (1.77) in Down syndrome cases compared to controls.
    • Dimeric inhibin-A alone identified 37% of Down syndrome cases at a 5% false-positive rate.
    • Combined screening (inhibin-A, AFP, free beta hCG, maternal age) achieved a 68% detection rate.
    • Higher median levels observed earlier in gestation (14-16 weeks: 1.92 MOM) compared to later (17-23 weeks: 1.46 MOM).

    Conclusions:

    • Dimeric inhibin-A is a valuable marker for Down syndrome screening in the second trimester.
    • Its efficacy is enhanced when combined with maternal age and other biochemical markers.
    • Dimeric inhibin-A shows greater potential as an early gestational screening tool, particularly in the first trimester.