How to correct the impact of ethnicity on effectiveness of the second trimester maternal serum screen of fetal Down syndrome?. (18th October 2019)

• Record Type: Journal Article
• Authors: Tana, Chonthicha; Wanapirak, Chanane; Sirichotiyakul, Supatra; Tongprasert, Fuanglada; Srisupundit, Kasemsri; Luewan, Suchaya; Sekararithi, Ratanaporn; Tongsong, Theera
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 32:Number 20(2019)
• Page Start: 3343
• Page End: 3347
• Publication Date: 2019-10-18
• Subjects: Alpha-tetoprotein -- Down syndrome -- beta-Human chorionic gonadotropin -- reference ranges -- screening -- unconjugated estriol; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2018.1463367
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objectives: To compare the performance of second trimester maternal serum screen (MSS) for fetal Down syndrome in Thai population between the conventional method using Caucasian reference ranges with ethnic factor correction (CRR-EC) and the method using specific Thai reference ranges (TRRs). Methods: A prospective database of the MSS project was accessed. The concentrations of alpha fetoprotein (AFP), beta-hCG, and uE3 were converted to their multiple of medians (MoMs) by two methods; CRR-EC for Asian women and TRR. The detection rate and false positive rate derived from the two methods were compared. Results: Of 20, 229 cases, 35 women had fetal Down syndrome. The detection rates of both methods were comparable, whereas the false-positive rate of TRR was significantly lower (8.8 versus 11.7%; p < .001). The improvement was mainly caused by more accuracy of the MoMs of beta-hCG, not AFP/uE3, based on TRR. Conclusions: The effectiveness of MSS could be improved by using our own reference ranges instead of using ethnic factor correction. With TRR, the false-positive rate or the number of invasive diagnoses could be significantly decreased without compromise of the detection rate. To improve MSS performance, each population should use its own reference ranges.