Racial differences in maternal serum human chorionic gonadotropin and unconjugated oestriol levels

Kulch, Peggy; Keener, Sherry L.; Matsumoto, Myles; Crandall, Barbara F.

doi:10.1002/pd.1970130306

Cited by 25 publications

(7 citation statements)

References 7 publications

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“…Several studies have reported racial differences in prenatal screening marker medians (Crandall et al, 1983;Canick et al, 1990;Bradley et al, 1991;Kulch et al, 1993;O'Brien et al, 1993), and investigators have reported differences between commercially available radioimmunoassay kits (Kallestad AFP/Ob Radioimmunoassay, Chaska, Minnesota, U.S.A.; Serono MAIAclone Immunoradiometric hCG assay, BIODATA, Milano, Italy; Unconjugated Estriol Radioimmunoassay, Diagnostic Systems Laboratory, Webster, Texas, U.S.A.). Additional information collected included date of birth, maternal age at delivery, gestational age, maternal weight, number of fetuses, insulindependent diabetes mellitus (IDDM) status, and any family history of DS or ONTD.…”

Section: Introductionmentioning

confidence: 99%

Triple Marker Screening in Native Japanese Women

et al. 1996

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Section: Introductionmentioning

confidence: 99%

Triple Marker Screening in Native Japanese Women

et al. 1996

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“…Such adjustment increases detec tion while decreasing the false-positive rate. The effect is less pronounced in Down syndrome screening, although higher hCG levels have also been reported in AfricanAmericans when compared with Caucasians [14,15]. A few studies have looked at Asian populations with similar findings of higher mid-trimester levels of hCG [16][17][18], O'Brien et al [ 17,18] looked at serum screening in a New York metropolitan area population, and found a consis tent pattern of analyte differences across all gestational ages, with highest values for all three analytes in Asians.…”

Section: Discussionmentioning

confidence: 96%

Effect of Hispanic Ethnicity on Interpretation of Maternal Serum Screening

Byrne

Waller²,

Rose

et al. 1997

Fetal Diagn Ther

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Maternal serum concentrations of α-fetoprotein (MSAFP), unconjugated estriol (uE₃) and human chorionic gonadotropin (hCG) were measured in the sera of 3,046 Hispanic women and of 15,154 Caucasian women from gestational weeks 14 through 20 between January 1990 and December 1995. Median values for analytes were calculated for each gestational week and the two ethnic groups compared. Our findings indicate that the median values for Hispanics are lower for MSAFP and hCG, but higher for estriol. These differences are not accounted for by differences in median weights of the two ethnic groups. Although these results would suggest that Hispanic women at risk for a fetus with a neural tube defect (NTD) may be missed when cut-offs derived from a Caucasian population are used, in fact, that was not the case in our screening population. However, a disproportionate number of Hispanic women may be identified with an abnormal serum screening test unrelated to a risk for neural tube defects. This does not infer that detection rates are different across different ethnic groups since other factors are involved. Adjustment of medians for Hispanic ethnicity may have a small but significant effect, especially with regard to low values.

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“…Most computer programs for the analysis of risk allow for this factor. Levels of hCG tend to be higher in Asian women [101] and black women [79,135], but because of some conflicting evidence corrections are usually not made for these factors. After 18 weeks gestation hCG levels are higher in the presence of a female fetus [71,81].…”

Section: Should Tests Be Repeated?mentioning

confidence: 99%

Review article

Chard

Macintosh²

1995

Jpme

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Down's syndrome (DS) is the commonest cause of severe mental retardation in children. It is the result of trisomy of chromosome 21 which is usually a random event though it is commoner in older mothers. DS can be diagnosed by chorionic villus sampling (CVS) and amniocentesis followed by karyotyping. Because of the risks associated with these invasive procedures, they can only be offered to a high-risk group. At one time the sole basis for identifying this increased risk was maternal age, but within the past ten years a series of biochemical and ultrasound abnormalities have been shown in DS pregnancies. The biochemical abnormalities include changes in the levels of most fetal and placental products in the maternal circulation. The best-known of these changes are the reduced levels of alphafetoprotein (AFP) and oestriol (E3) and increased levels of human chorionic gonadotrophin (hCG). The mechanism underlying these biochemical phenomena is unknown. Screening programmes involving the measurement of hCG and AFP, with or without additional parameters such as E3, at 15-18 weeks of pregnancy can typically identify 60% or more of cases of DS with a screen-positive rate of 5%. The combined risk derived from the various biochemical parameters, together with maternal age, is calculated by one of a number of computer programmes which have been developed for this purpose. There has been considerable discussion as to the exact biochemical tests which should be used for DS screening. This had led to controversy as to whether measurement of E3 has a place, and whether or not measurement of the free beta-subunit of hCG should replace measurement of the intact molecule. A notable recent development is the suggestion that measurement of the urinary beta-core of the hCG could be a highly discriminatory marker. A number of factors can affect the results of biochemical screening for DS. These include maternal weight, gestational age, ethnic origin, smoking, and diabetes. In addition, abnormal levels of the biochemical products may be found in other chromosome abnormalities.

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Racial differences in maternal serum human chorionic gonadotropin and unconjugated oestriol levels

Cited by 25 publications

References 7 publications

Triple Marker Screening in Native Japanese Women

Triple Marker Screening in Native Japanese Women

Effect of Hispanic Ethnicity on Interpretation of Maternal Serum Screening

Review article

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