Modeling Down syndrome screening performance using first‐trimester serum markers

Koster, Maria P. H.; Wortelboer, E. J.; Stoutenbeek, P.; Visser, Gerard H.A.; Schielen, Peter C. J. I.

doi:10.1002/uog.8881

Cited by 27 publications

(29 citation statements)

References 24 publications

(28 reference statements)

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“…The finding that in trisomy-21 pregnancies serum PLGF at 11–13 weeks’ gestation is reduced is compatible with the results of previous case-control studies [6,7,8,9]. In a few of our cases of trisomy-21 examined before 11 weeks, the levels of PLGF were also lower than in euploid pregnancies and the PLGF MoM in trisomic fetuses did not change significantly with gestational age between 8 and 13 weeks.…”

Section: Discussionsupporting

confidence: 81%

“…Two recent studies reporting in trisomy-21 pregnancies at 8–10 weeks reported contradictory results. Koster et al [8], who examined 151 cases of trisomy-21 at 8–13 weeks, including 60 at 8–10 weeks, found that the median PLGF MoM was 0.8 and this did not change significantly with gestational age, whereas Cowans et al [9] reported that the median MoM in 37 affected cases was increased to 1.3. A possible explanation for the findings of Cowans et al [9] is that the concentration of PLGF increases with storage time, because their samples from the trisomy-21 pregnancies were stored for up to 9 years, whereas the controls were assayed within 1 year of collection.…”

Section: Discussionmentioning

confidence: 99%

“…Maternal serum levels of PLGF at 11–13 weeks’ gestation are decreased in pregnancies with impaired placentation resulting in preeclampsia and delivery of small for gestational age (SGA) neonates [4,5]. Case-control studies have reported that maternal serum PLGF at 11–13 weeks is also decreased in fetal trisomy-21, but there is contradictory evidence concerning levels in affected pregnancies at 8–10 weeks [6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Maternal Serum Placental Growth Factor in Prospective Screening for Aneuploidies at 8–13 Weeks’ Gestation

et al. 2012

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Objective: To investigate whether measurement of maternal serum placental growth factor (PLGF) can improve the performance of first-trimester combined screening for trisomy-21 by fetal nuchal translucency (NT) thickness and serum free β-human chorionic gonadotropin (β-hCG) and PAPP-A. Methods: In singleton pregnancies attending for routine care, serum PLGF, free β-hCG and PAPP-A were measured at 8⁺⁰–13⁺⁶ weeks’ gestation, and fetal NT was measured at 11⁺⁰–13⁺⁶ weeks. The population included 12,154 normal and 44 trisomy-21 pregnancies. We examined the effect of adding PLGF on the performance of screening by the combined test. Results: In the trisomy-21 pregnancies the median multiple of the normal median PLGF, adjusted for gestational age, maternal weight, racial origin, smoking status and method of conception, was significantly reduced (0.6070, 95% CI 0.5543–0.6648), and this did not change significantly with gestational age. Adding PLGF to combined testing with a risk cut-off of 1 in 100 reduced the false positive rate from 2.7% (95% CI 2.5–3.0) to 2.6% (95% CI 2.4–2.8) and increased the detection rate from 85% (95% CI 75–93) to 88% (95% CI 78–95). Conclusions: Inclusion of serum PLGF improves the performance of the first-trimester combined test in screening for trisomy-21.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternal Serum Placental Growth Factor in Prospective Screening for Aneuploidies at 8–13 Weeks’ Gestation

et al. 2012

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“…Total hCG (thCG), which is a screening marker for DS in the second trimester of pregnancy, is increased in maternal serum from first-trimester DS pregnancies (Hallahan et al, 2000). However, when these four markers were added to the current first-trimester combined test algorithm the DR increased by only 3% (table 2a) (Koster et al, 2010d). These studies show that the predictive power of maternal serum markers is not constant during the first trimester.…”

Section: Proteomics Techniques To Identify New Screening Markers For mentioning

confidence: 94%

Innovations in Down Syndrome Screening

Koster¹,

Vries²,

Visser³

et al. 2011

Prenatal Diagnosis and Screening for Down Syndrome

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“…In the first trimester, PlGF levels in trisomy 21 cases have been found to be both increased [9,10] and decreased [11,12,13] compared to euploid controls. In part, this may be down to the precise gestational age at sampling.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Two Immunoassay Methods for the Measurement of Maternal Serum Placental Growth Factor in Early Pregnancy

Cowans

Kisanga²,

Khan³

et al. 2012

Fetal Diagn Ther

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Objectives: To compare the DELFIA Xpress and Quantikine ELISA placental growth factor (PlGF) immunoassay platforms by analysing the same set of early first-trimester maternal serum samples from cases with trisomy 21 and euploid controls. Methods: Thirty-seven trisomy 21 cases and 243 euploid control serum samples, drawn at 8⁺⁰ to 10⁺⁶ weeks of gestation, were reanalysed by Quantikine PlGF ELISA following original analysis on the DELFIA Xpress platform. Results: PlGF levels increased with gestation in the euploid controls when measured on both platforms, although raw levels were in general lower on the DELFIA Xpress. After conversion to multiples of the median (MoMs), PlGF was increased in trisomy 21 cases when measured on the DELFIA Xpress platform (euploid: 1.00 MoM, trisomy 21: 1.32 MoM, p < 0.0001) but unchanged when measured on the Quantikine ELISA (euploid: 1.01 MoM, trisomy 21: 1.06 MoM, p = 0.84). Conclusions: Discrepancies exist in the measurement of PlGF when performed on these different platforms, which may to some extent contribute to the inconsistencies found in the literature with regard to PlGF in trisomy 21 pregnancies.

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Modeling Down syndrome screening performance using first‐trimester serum markers

Abstract: Objective To evaluate the modeled predictive value of three current screening markers (pregnancy-associated plasma protein-A (PAPP-A

Cited by 27 publications

References 24 publications

Maternal Serum Placental Growth Factor in Prospective Screening for Aneuploidies at 8–13 Weeks’ Gestation

Maternal Serum Placental Growth Factor in Prospective Screening for Aneuploidies at 8–13 Weeks’ Gestation

Innovations in Down Syndrome Screening

A Comparison of Two Immunoassay Methods for the Measurement of Maternal Serum Placental Growth Factor in Early Pregnancy

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