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Screening for Down's syndrome in older women based on maternal serum alpha‐fetoprotein levels and age: Preliminary results
Author(s) -
Zeitune Moshe,
BenTovim Talma,
Fejgin Moshe,
Amiel Aliza,
Beyth Yoram
Publication year - 1991
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.1970110609
Subject(s) - amniocentesis , medicine , trisomy , down syndrome , obstetrics , advanced maternal age , prenatal diagnosis , pregnancy , gynecology , pediatrics , fetus , biology , genetics , psychiatry
We report the results of screening for Down's syndrome (DS) in older women using published rate schedules based on maternal serum alpha‐fetoprotein (MSAFP) and age. Five hundred and seventeen patients aged 35 years and older, who were referred for a mid‐trimester genetic amniocentesis, were first tested for MSAFP and then underwent an amniocentesis. Individual risks for DS, combining MSAFP and age, were derived using three different published rate schedules. Theoretical selection for amniocentesis was made using the cut‐off level of the average collective risk for a 35‐year‐old woman (1:380 at live birth or 1:270 at amniocentesis). Six affected pregnancies (five with DS and one with trisomy 18), which were diagnosed prenatally, were all found to be at a higher risk than the specified cut‐off. These cases would have been diagnosed in any event, using any of the published rate schedules. According to these rate schedules, between 39 and 45 per cent of the patients would be in the lower risk group and therefore would have been counselled not to undergo amniocentesis. Further studies should be conducted in order to reach conclusive screening policies for DS in older women.