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Contingent triple‐screening for Down syndrome in the second trimester: a feasibility study in Mainland Chinese population
Author(s) -
Xie Zhenwei,
Lu Shiming,
Li Hui
Publication year - 2010
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.2412
Subject(s) - triple test , prenatal screening , medicine , obstetrics , estriol , antenatal screening , population , pregnancy , gynecology , pediatrics , prenatal diagnosis , estrogen , environmental health , fetus , biology , genetics
Objectives To explore the efficacy of contingent triple‐screening for Down syndrome (DS), that is, performing triple‐screening in pregnant women with DS risks between 1/270 and 1/1000 at routine double‐screening, in a Mainland Chinese population. Methods Maternal serum concentrations of alpha fetoprotein (AFP), free‐beta human chorionic gonadotropin (free β‐hCG), and unconjugated estriol (uE3) were measured by time‐resolved fluoroimmunoassay in 24 double‐screening false‐negative (DSFN) and 322 double‐screening true‐negative (DSTN) pregnancies with DS risks between 1/270 and 1/1000 at routine double‐screening performed at 15–20 weeks' gestation. DS risk of each pregnancy was calculated by computer software. The detection rate (DR), false‐positive rate (FPR), and costs of contingent triple‐screening were calculated and compared with routine double‐screening methods. Results Six of 24 DSFN and 3 of 322 DSTN were contingent triple‐screening positive. Compared with routine double‐screening, DR of contingent triple‐screening increased by 10% (from 50% to 60%) without a significant increase of FPR ( p > 0.05). When compared with routine triple‐screening, uE3 costs in contingent triple‐screening were reduced by more than 84.3%. Conclusions Second‐trimester maternal serum contingent triple‐screening could be effective and suitable for prenatal care in Mainland China. Governments and Health Agencies of other developing countries may also find this strategy cost‐effective. Copyright © 2009 John Wiley & Sons, Ltd.