Maternal serum screening for fetal Down syndrome using alpha-fetoprotein, human chorionic gonadotrophin, and unconjugated estriol in adolescents

Owen Phillips, L. P. Shulman, S. Elias, J. L. Simpson

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Study Objective: To learn whether accuracy and false-positive rate of our maternal serum screening program for fetal Down syndrome differed in adolescents compared with adults. In addition, we studied the degree to which overestimated gestational age accounted for screen-positive results and the rate at which amniocentesis was elected by patients in different age groups. Design: Maternal serum screening using human chorionic gonadotropin (hCG), alpha-fetoprotein, unconjugated estriol and age was offered for fetal Down syndrome to all women between 15 and 20 weeks gestation who were less than or equal to 35 years of age at date of delivery. Women found to have a risk for fetal Down syndrome of ≥1:274 were considered screen-positive. If gestational age was confirmed by ultrasound, then genetic counseling and amniocentesis were offered. Results: Of 10,627 women screened, 2,237 (21.1% of population screened) were between ages 12 and 19 years. Of these adolescents, 175 (7.5%) were screen positive. Of these 175, 114 (65.1%) were found by ultrasonographic examination to have overestimated gestational age, and compared with adult women (ages 20-34 years); this was statistically significant (p < 0.003). Of the remaining 61 patients, 13 (21.3%) were lost to follow-up. The remaining 48 were offered genetic counseling and amniocentesis, of whom 38 (79.2%) elected to have amniocentesis. In the total population screened, four of seven Down syndrome cases were detected, one in a 19-year-old. In the three cases not detected, one was in a 19-year-old and one was in a 22-year-old. Conclusions: Fetal Down syndrome screening may not be as sensitive in younger women as in older women, however, counseling and management in adolescents need not differ from that of adults. Appropriate diagnostic procedures should be offered to all women at increased risk for fetal Down syndrome.

Original languageEnglish (US)
Pages (from-to)91-94
Number of pages4
JournalAdolescent and Pediatric Gynecology
Volume6
Issue number2
DOIs
StatePublished - Jan 1 1993
Externally publishedYes

Fingerprint

Estriol
alpha-Fetoproteins
Chorionic Gonadotropin
Down Syndrome
Mothers
Amniocentesis
Serum
Gestational Age
Genetic Counseling
Lost to Follow-Up
Population
Counseling
Age Groups
Pregnancy

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Maternal serum screening for fetal Down syndrome using alpha-fetoprotein, human chorionic gonadotrophin, and unconjugated estriol in adolescents. / Phillips, Owen; Shulman, L. P.; Elias, S.; Simpson, J. L.

In: Adolescent and Pediatric Gynecology, Vol. 6, No. 2, 01.01.1993, p. 91-94.

Research output: Contribution to journalArticle

@article{8867a3106a504b5095326e2a8eed1835,
title = "Maternal serum screening for fetal Down syndrome using alpha-fetoprotein, human chorionic gonadotrophin, and unconjugated estriol in adolescents",
abstract = "Study Objective: To learn whether accuracy and false-positive rate of our maternal serum screening program for fetal Down syndrome differed in adolescents compared with adults. In addition, we studied the degree to which overestimated gestational age accounted for screen-positive results and the rate at which amniocentesis was elected by patients in different age groups. Design: Maternal serum screening using human chorionic gonadotropin (hCG), alpha-fetoprotein, unconjugated estriol and age was offered for fetal Down syndrome to all women between 15 and 20 weeks gestation who were less than or equal to 35 years of age at date of delivery. Women found to have a risk for fetal Down syndrome of ≥1:274 were considered screen-positive. If gestational age was confirmed by ultrasound, then genetic counseling and amniocentesis were offered. Results: Of 10,627 women screened, 2,237 (21.1{\%} of population screened) were between ages 12 and 19 years. Of these adolescents, 175 (7.5{\%}) were screen positive. Of these 175, 114 (65.1{\%}) were found by ultrasonographic examination to have overestimated gestational age, and compared with adult women (ages 20-34 years); this was statistically significant (p < 0.003). Of the remaining 61 patients, 13 (21.3{\%}) were lost to follow-up. The remaining 48 were offered genetic counseling and amniocentesis, of whom 38 (79.2{\%}) elected to have amniocentesis. In the total population screened, four of seven Down syndrome cases were detected, one in a 19-year-old. In the three cases not detected, one was in a 19-year-old and one was in a 22-year-old. Conclusions: Fetal Down syndrome screening may not be as sensitive in younger women as in older women, however, counseling and management in adolescents need not differ from that of adults. Appropriate diagnostic procedures should be offered to all women at increased risk for fetal Down syndrome.",
author = "Owen Phillips and Shulman, {L. P.} and S. Elias and Simpson, {J. L.}",
year = "1993",
month = "1",
day = "1",
doi = "10.1016/S0932-8610(12)80224-6",
language = "English (US)",
volume = "6",
pages = "91--94",
journal = "Journal of Pediatric and Adolescent Gynecology",
issn = "1083-3188",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Maternal serum screening for fetal Down syndrome using alpha-fetoprotein, human chorionic gonadotrophin, and unconjugated estriol in adolescents

AU - Phillips, Owen

AU - Shulman, L. P.

AU - Elias, S.

AU - Simpson, J. L.

PY - 1993/1/1

Y1 - 1993/1/1

N2 - Study Objective: To learn whether accuracy and false-positive rate of our maternal serum screening program for fetal Down syndrome differed in adolescents compared with adults. In addition, we studied the degree to which overestimated gestational age accounted for screen-positive results and the rate at which amniocentesis was elected by patients in different age groups. Design: Maternal serum screening using human chorionic gonadotropin (hCG), alpha-fetoprotein, unconjugated estriol and age was offered for fetal Down syndrome to all women between 15 and 20 weeks gestation who were less than or equal to 35 years of age at date of delivery. Women found to have a risk for fetal Down syndrome of ≥1:274 were considered screen-positive. If gestational age was confirmed by ultrasound, then genetic counseling and amniocentesis were offered. Results: Of 10,627 women screened, 2,237 (21.1% of population screened) were between ages 12 and 19 years. Of these adolescents, 175 (7.5%) were screen positive. Of these 175, 114 (65.1%) were found by ultrasonographic examination to have overestimated gestational age, and compared with adult women (ages 20-34 years); this was statistically significant (p < 0.003). Of the remaining 61 patients, 13 (21.3%) were lost to follow-up. The remaining 48 were offered genetic counseling and amniocentesis, of whom 38 (79.2%) elected to have amniocentesis. In the total population screened, four of seven Down syndrome cases were detected, one in a 19-year-old. In the three cases not detected, one was in a 19-year-old and one was in a 22-year-old. Conclusions: Fetal Down syndrome screening may not be as sensitive in younger women as in older women, however, counseling and management in adolescents need not differ from that of adults. Appropriate diagnostic procedures should be offered to all women at increased risk for fetal Down syndrome.

AB - Study Objective: To learn whether accuracy and false-positive rate of our maternal serum screening program for fetal Down syndrome differed in adolescents compared with adults. In addition, we studied the degree to which overestimated gestational age accounted for screen-positive results and the rate at which amniocentesis was elected by patients in different age groups. Design: Maternal serum screening using human chorionic gonadotropin (hCG), alpha-fetoprotein, unconjugated estriol and age was offered for fetal Down syndrome to all women between 15 and 20 weeks gestation who were less than or equal to 35 years of age at date of delivery. Women found to have a risk for fetal Down syndrome of ≥1:274 were considered screen-positive. If gestational age was confirmed by ultrasound, then genetic counseling and amniocentesis were offered. Results: Of 10,627 women screened, 2,237 (21.1% of population screened) were between ages 12 and 19 years. Of these adolescents, 175 (7.5%) were screen positive. Of these 175, 114 (65.1%) were found by ultrasonographic examination to have overestimated gestational age, and compared with adult women (ages 20-34 years); this was statistically significant (p < 0.003). Of the remaining 61 patients, 13 (21.3%) were lost to follow-up. The remaining 48 were offered genetic counseling and amniocentesis, of whom 38 (79.2%) elected to have amniocentesis. In the total population screened, four of seven Down syndrome cases were detected, one in a 19-year-old. In the three cases not detected, one was in a 19-year-old and one was in a 22-year-old. Conclusions: Fetal Down syndrome screening may not be as sensitive in younger women as in older women, however, counseling and management in adolescents need not differ from that of adults. Appropriate diagnostic procedures should be offered to all women at increased risk for fetal Down syndrome.

UR - http://www.scopus.com/inward/record.url?scp=0027312230&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027312230&partnerID=8YFLogxK

U2 - 10.1016/S0932-8610(12)80224-6

DO - 10.1016/S0932-8610(12)80224-6

M3 - Article

VL - 6

SP - 91

EP - 94

JO - Journal of Pediatric and Adolescent Gynecology

JF - Journal of Pediatric and Adolescent Gynecology

SN - 1083-3188

IS - 2

ER -