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Triple-marker test as screening for Down syndrome: a meta-analysis
A Conde-Agudelo1, A C Kafury-Goeta
1Department of Obstetrics and Gynecology of the Carlos Holmes Trujillo Hospital, Cali, Colombia, South America.
Obstetrical & Gynecological Survey
|June 10, 1998
Summary
Triple-marker testing effectively screens for Down syndrome pregnancies. This method is more accurate for older women and can be an alternative to amniocentesis for those over 35.
Area of Science:
- Maternal-Fetal Medicine
- Prenatal Diagnostics
- Genetics Screening
Background:
- Down syndrome screening is crucial for prenatal care.
- Triple-marker testing offers a non-invasive screening option.
- Meta-analysis is needed to formally evaluate its effectiveness.
Purpose of the Study:
- To evaluate the effectiveness of triple-marker testing for Down syndrome detection.
- To compare sensitivities and false-positive rates across different study groups.
- To determine optimal cutoffs for screening.
Main Methods:
- Conducted a MEDLINE search and reviewed reference lists for eligible studies (1966-1996).
- Included 20 cohort studies encompassing 194,326 patients.
- Utilized summary receiver-operating characteristic (SROC) curve analysis to compare results.
Main Results:
- Median sensitivities for all ages ranged from 67% to 73% depending on cutoff.
- Median false-positive rates were between 4% and 8%.
- For women ≥35 years, sensitivity was 89% with a 1:190-200 cutoff; for women <35 years, sensitivity was 57% with a 1:250-295 cutoff.
Conclusions:
- Triple-marker testing is an effective screening method for Down syndrome pregnancies.
- Effectiveness varies by maternal age, being higher in older women.
- It can serve as an alternative to amniocentesis for pregnant women over 35.