Oviedo-Cruz H, Reyes-Mendoza MÁ, Mestizo-Reyes V

Language: Spanish
References: 31
Page: 787-798
PDF size: 827.51 Kb.

ABSTRACT

Objetive: To determine whether first trimester serum markers distribution on a Mexican population sample differ from The Fetal Medicine Foundation (FMF) risks model, and to calculate the necessary correction factors for accurate test performance.
Materials and Method: Transverse descriptive study, Freebeta- hCG and PAPP-A were measured on unselected first trimester maternal sera using FMF approved electrochemiluminescence assay, the adjusted MoM were obtained from FMF algorithm (astraia); they were log10 transformed to describe each marker distribution and to test their statistical difference with the 0.000 ideal mean by one sample t-test. MoM distributions for pregnancy characteristics and reagent lot are additionally described.
Results: On 1008 sera, the overall adjusted log10MoM was -0.121 ± 0.2706 SD for Free-beta-hCG and -0.049 ± 0.2372 SD for PAPP-A; these distributions differed significantly from tåzhe expected by FMF risks model.
Conclusions: Free-beta-hCG and PAPP-A distributions on this Mexican population sample differ from expected for population similar to Hispanic European, median correction factors of 0.756 MoM and of 0.893 MoM, respectively, are recommended for the algorithm.

REFERENCES

1. Cuckle HS and van Lith JM. Appropriate biochemical parameters in first-trimester screening for Down syndrome. Prenat Diagn 1999;19:505-12.

2. de Graaf IM, Pajkrt E, Bilardo CM, Leschot NJ, Cuckle HS, et al. Early pregnancy screening for fetal aneuploidy with serum markers and nuchal translucency. Prenat Diagn 1999;19:458-62.

3. Spencer K, Souter V, Tul N, Snijders R, Nicolaides KH. A screening program for trisomy 21 at 10-14 weeks using fetal nuchal translucency, maternal serum free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A. Ultrasound Obstet Gynecol 1999;13:231-7.

4. Spencer K, Spencer CE, Power M, Dawson C and Nicolaides KH. Screening for chromosomal abnormalities in the first trimester using ultrasound and maternal serum biochemistry in a one-stop clinic: a review of three years prospective experience. BJOG 2003;110:281-6.

5. Cicero S, Bindra R, Rembouskos G, Spencer K and Nicolaides KH. Integrated ultrasound and biochemical screening for trisomy 21 using fetal nuchal translucency, absent fetal nasal bone, free beta-hCG and PAPP-A at 11 to 14 weeks. Prenat Diagn 2003;23:306-10.

6. Haddad B, Abirached F, Louis-Sylvestre C, Le Blond J, Paniel BJ, et al. Predictive value of early human chorionic gonadotrophin serum profiles for fetal growth retardation. Hum Reprod 1999;14:2872-5.

7. Smith GC, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD, et al. Early pregnancy levels of pregnancy-associated plasma protein a and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab 2002;87:1762-7.

8. Spencer K, Cowans NJ, Avgidou K, Molina F and Nicolaides KH. First-trimester biochemical markers of aneuploidy and the prediction of small-for-gestational age fetuses. Ultrasound Obstet Gynecol 2008;31:15-9.

9. Spencer K, Cowans NJ, Molina F, Kagan KO and Nicolaides KH. First-trimester ultrasound and biochemical markers of aneuploidy and the prediction of preterm or early preterm delivery. Ultrasound Obstet Gynecol 2008;31:147-52.

10. Spencer K, Cowans NJ and Nicolaides KH. Low levels of maternal serum PAPP-A in the first trimester and the risk of pre-eclampsia. Prenat Diagn 2008;28:7-10.

11. Poon LC, Kametas NA, Maiz N, Akolekar R and Nicolaides KH. First-trimester prediction of hypertensive disorders in pregnancy. Hypertension 2009;53:812-8.

12. Poon LC, Maiz N, Valencia C, Plasencia W and Nicolaides KH. First-trimester maternal serum pregnancy-associated plasma protein-A and pre-eclampsia. Ultrasound Obstet Gynecol 2009;33:23-33.

13. Poon LC, Akolekar R, Lachmann R, beta J and Nicolaides KH. Hypertensive disorders in pregnancy: screening by biophysical and biochemical markers at 11-13 weeks. Ultrasound Obstet Gynecol 2010;35:662-70.

14. Poon LC, Stratieva V, Piras S, Piri S and Nicolaides KH. Hypertensive disorders in pregnancy: combined screening by uterine artery Doppler, blood pressure and serum PAPP-A at 11-13 weeks. Prenat Diagn 2010;30:216-23.

15. Spencer K. First trimester maternal serum screening for Down's syndrome: an evaluation of the DPC Immulite 2000 free beta-hCG and pregnancy-associated plasma protein-A assays. Ann Clin Biochem 2005;42:30-40.

16. Spencer K, Ong CY, Liao AW and Nicolaides KH. The influence of ethnic origin on first trimester biochemical markers of chromosomal abnormalities. Prenat Diagn 2000;20:491-4.

17. Cicero S, Spencer K, Avgidou K, Faiola S and Nicolaides KH. Maternal serum biochemistry at 11-13(+6) weeks in relation to the presence or absence of the fetal nasal bone on ultrasonography in chromosomally abnormal fetuses: an updated analysis of integrated ultrasound and biochemical screening. Prenat Diagn 2005;25:977-83.

18. Krantz DA, Hallahan TW, Macri VJ and Macri JN. Maternal weight and ethnic adjustment within a first-trimester Down syndrome and trisomy 18 screening program. Prenat Diagn 2005;25:635-40.

19. Spencer K, Heath V, El-Sheikhah A, Ong CY and Nicolaides KH. Ethnicity and the need for correction of biochemical and ultrasound markers of chromosomal anomalies in the first trimester: a study of Oriental, Asian and Afro- Caribbean populations. Prenat Diagn 2005;25:365-9.

20. Ardawi MS, Nasrat HA, Rouzi AA, Qari MH, Al-Qahtani MH, et al. Maternal serum free-beta-chorionic gonadotrophin, pregnancy- associated plasma protein-A and fetal nuchal translucency thickness at 10-13(+6) weeks in relation to co-variables in pregnant Saudi women. Prenat Diagn 2007;27:303-11.

21. Sahota DS, Leung TY, Fung TY, Chan LW, Law LW, et al. Medians and correction factors for biochemical and ultrasound markers in Chinese women undergoing firsttrimester screening for trisomy 21. Ultrasound Obstet Gynecol 2009;33:387-93.

22. Kagan KO, Wright D, Baker A, Sahota D and Nicolaides KH. Screening for trisomy 21 by maternal age, fetal nuchal translucency thickness, free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A. Ultrasound Obstet Gynecol 2008;31:618-24.

23. Kagan KO, Wright D, Spencer K, Molina FS and Nicolaides KH. First-trimester screening for trisomy 21 by free betahuman chorionic gonadotropin and pregnancy-associated plasma protein-A: impact of maternal and pregnancy characteristics. Ultrasound Obstet Gynecol 2008;31:493-502.

24. Benn PA, Clive JM and Collins R. Medians for secondtrimester maternal serum alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol; differences between races or ethnic groups. Clin Chem 1997;43:333-7.

25. Wetta L, Biggio J and Owen J. Use of ethnic-specific medians for Hispanic patients reduces ethnic disparities in multiple marker screening. Prenatal Diagnosis 2011;31:331-333.

26. Oviedo-Cruz H, Hernandez-Paredez J and Ruiz-Ramirez AV. Tamiz prenatal de aneuploidías en el primer trimestre: auditoría a un centro de medicina fetal con laboratorio especializado en México. Ginecol Obstet Mex 2015;83:259-76.

27. Nicolaides KHFO. La ecografía de las 11–13+6 semanas. Londres, Reino Unido: Fetal Medicine Foundation; 2004. Dreccion URL: .

28. Spencer K. FMF Certification of Biochemical Laboratories. dirección URL: .

29. Robinson HP and Fleming JE. A critical evaluation of sonar "crown-rump length" measurements. Br J Obstet Gynaecol 1975;82:702-10.

30. Loughna P, Chitty L, Evans T and Chudleigh T. Fetal Size and Dating: Charts Recommended for Clinical Obstetric Practice. Ultrasound 2009;17:160-166.

31. van Heesch PN, de Rijke YB, Laudy JA and Wildschut HI. Erroneous production of PAPP-A kits: the impact of a downward shift in PAPP-A concentration on the test performance of first-trimester combined screening for Down syndrome. Prenat Diagn 2011;31:821-6.