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Maternal serum screening for Down syndrome in the United States: a 1995 survey
G E Palomaki1, G J Knight, J E McCarthy
1Foundation for Blood Research, Scarborough, ME 04070-0190, USA.
Objective:
Our goal was to determine the status of prenatal Down syndrome screening in the United States in 1995.
Study Design:
Information was sought via questionnaire from laboratories participating in external proficiency testing.
Results:
Services were provided to 2,498,000 women annually by 265 screening laboratories. All but 10 laboratories offered both open neural tube defect and Down syndrome screening. Twenty-one percent of Down syndrome interpretations were based on alpha-fetoprotein measurements alone; 79% also included other serum analytes. Sixty-six laboratories (26%) offered interpretations at 14 weeks' gestation or earlier.
Conclusions:
Some laboratories extend serum screening too early in gestation for optimal neural tube defect interpretation. When 1995 was compared with 1992, more women were being screened, a higher proportion were receiving a Down syndrome interpretation, and more interpretations were based on multiple analytes. Laboratories should be encouraged to use some combination of multiple markers when screening for Down syndrome.