Effect of ethnicity on first trimester biomarkers for combined trisomy 21 screening: results from a multicenter study in six Asian countries

Manotaya, Saknan; Zitzler, Juergen; Li, Xiaotian; Wibowo, Noroyono; Pham, Thi Mai; Kang, Minhee; Lee, Chien‐Nan

doi:10.1002/pd.4602

Cited by 18 publications

(13 citation statements)

References 16 publications

(37 reference statements)

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“…Earlier studies have shown that adjustment for differing ethnicities increases the sensitivity of the test [6, 7]. However, this is achieved at the cost of an increased number of false positives which leads to more invasive procedures being conducted.…”

Section: Discussionmentioning

confidence: 99%

“…For example, a comparable study by Leung et al [6] found that Chinese women have a higher level of both serum markers in the maternal circulation than Caucasian women. To ensure that screening is effective, population-specific models for median levels of PAPP-A, and free β-hCG should be developed to provide more accurate risk calculations [6, 7]. …”

Section: Introductionmentioning

confidence: 99%

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Normative weight-adjusted models for the median levels of first trimester serum biomarkers for trisomy 21 screening in a specific ethnicity

et al. 2017

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ObjectiveTo establish normative weight-adjusted models for the median levels of first trimester serum biomarkers for trisomy 21 screening in southern Thai women, and to compare these reference levels with Caucasian-specific and northern Thai models.MethodsA cross-sectional study was conducted in 1,150 normal singleton pregnancy women to determine serum pregnancy-associated plasma protein-A (PAPP-A) and free β-human chorionic gonadotropin (β-hCG) concentrations in women from southern Thailand. The predicted median values were compared with published equations for Caucasians and northern Thai women.ResultsThe best-fitting regression equations for the expected median serum levels of PAPP-A (mIU/L) and free β- hCG (ng/mL) according to maternal weight (Wt in kg) and gestational age (GA in days) were: and Both equations were selected with a statistically significant contribution (p< 0.05). Compared with the Caucasian model, the median values of PAPP-A were higher and the median values of free β-hCG were lower in the southern Thai women. And compared with the northern Thai models, the median values of both biomarkers were lower in southern Thai women.ConclusionThe study has successfully developed maternal-weight- and gestational-age-adjusted median normative models to convert the PAPP-A and free β-hCG levels into their Multiple of Median equivalents in southern Thai women. These models confirmed ethnic differences.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Normative weight-adjusted models for the median levels of first trimester serum biomarkers for trisomy 21 screening in a specific ethnicity

et al. 2017

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“…4 The screening performance of the combined test has been reported to range from 82 to 95% detection rate, with a 5 to 7% false positive (FP) rate. [5][6][7][8][9][10][11][12][13][14][15] However, it may vary between different ethnicities as well as by age group. [16][17][18] According to the Fetal Medicine Foundation (FMF) proposed screening, patients with a risk lower than 1:1,000 are classified as low risk and are reassured.…”

Section: Introductionmentioning

confidence: 99%

First-trimester Combined Screening Test for Aneuploidies in Brazilian Unselected Pregnancies: Diagnostic Performance of Fetal Medicine Foundation Algorithm

Abib

Sá

Peixoto‐Filho

2018

Rev Bras Ginecol Obstet

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“…Several studies demonstrated an association between individual marker levels and rate of FGR, but most studies have only a limited number of women, and it is di cult to implement these ndings in actual use. Moreover, it is well established that racial factors strongly impact on serum marker levels (9)(10)(11)(12)(13) , and the normative data of serum biomarkers derived from Caucasian women cannot accurately be interpreted when used in other parts of the world. Though several studies have linked abnormal serum marker levels to higher rate of FGR, no study provides objective methods or models derived from individual serum markers that can be clinically used to determine the probability of FGR.…”

Section: Introductionmentioning

confidence: 99%

Quad test for fetal aneuploidy screening as a predictor of fetal growth restriction: A population-based study

Boonpiam

Wanapirak

Sirichotiyakul

et al. 2020

Preprint

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Background: To identify the relationship between quadruple test for aneuploidy screening (alpha-fetoprotein: AFP; free beta-human chorionic gonadotropin: b-hCG; unconjugated estriol: uE3 and inhibin-A: IHA) and fetal growth restriction and to construct predictive models for fetal growth restriction (FGR).Methods: Women who underwent quadruple test for aneuploidy were followed-up for final outcomes. The multiple of median (MoMs) of the four biochemical markers for the FGR group and those of normal fetuses were compared. The models for predicting FGR by the individual biomarkers and their combination were constructed using binary logistic regression analysis, and their diagnostic performances in predicting FGR were determined.Results: Of 10,155 eligible pregnant women, 578 (5.7%) and 9577 (94.3%) had FGR and normal growth, respectively. High levels of AFP, b-hCG and IHA but low levels of uE3 significantly increased the risk of FGR. The constructed predictive equations had predictive performance for FGR, with areas under the receiver-operated characteristic curve of 0.724, 0.655, 0.597, 0.664 and 0.754 for AFP, b-hCG, uE3, IHA, and the combination, respectively.Conclusion: The quad test for aneuploidy screening could also be used as a predictor of FGR, without extra-effort and extra-cost.

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Effect of ethnicity on first trimester biomarkers for combined trisomy 21 screening: results from a multicenter study in six Asian countries

Abstract: The use of a correction factor is recommended based on the differences in European and Asian MoM values. Developing country-specific medians in larger study populations can help identify clinical relevant differences and give the opportunity to explore a more accurate risk calculation.

Cited by 18 publications

References 16 publications

Normative weight-adjusted models for the median levels of first trimester serum biomarkers for trisomy 21 screening in a specific ethnicity

Normative weight-adjusted models for the median levels of first trimester serum biomarkers for trisomy 21 screening in a specific ethnicity

First-trimester Combined Screening Test for Aneuploidies in Brazilian Unselected Pregnancies: Diagnostic Performance of Fetal Medicine Foundation Algorithm

Quad test for fetal aneuploidy screening as a predictor of fetal growth restriction: A population-based study

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