Triple-marker prenatal screening program for chromosomal defects

Authors

  • N. Neely Kazerouni California Department of Public Health, Richmond, California, United States
  • Bob Currier California Department of Public Health, Richmond, California, United States
  • Linda Malm California Department of Public Health, Richmond, California, United States
  • Susan Riggle California Department of Public Health, Richmond, California, United States
  • Christina Hodgkinson California Department of Public Health, Richmond, California, United States
  • Sylvia Smith California Department of Public Health, Richmond, California, United States
  • Corinna Tempelis California Department of Public Health, Richmond, California, United States
  • Fred Lorey California Department of Public Health, Richmond, California, United States
  • Amber Davis California Department of Public Health, Richmond, California, United States
  • Laura Jelliffe-Pawlowski California Department of Public Health, Richmond, California, United States
  • Lynn Walton-Haynes California Department of Public Health, Richmond, California, United States
  • Marie Roberson California Department of Public Health, Richmond, California, United States

DOI:

https://doi.org/10.18370/2309-4117.2014.16.84-90

Keywords:

chromosomal abnormalities, Down syndrome, prenatal screening, triple marker screening

Abstract

To examine screening performance of California’s triple-marker screening program, using data from a statewide registry for chromosomal defects.

This study included 752,686 women who received a screening risk and had an expected date of delivery between July 2005 and the end of June 2007. Follow-up diagnostic services for screen-positive women were performed at state-approved centers. Data on diagnostic outcomes from these visits were entered into the California Chromosomal Defect Registry (CCDR). Other CCDR sources include mandatory reporting by all cytogenetic laboratories and hospitals and outcome data forms submitted by prenatal care providers.

The observed detection rate for Down syndrome (n = 1,217) was 77,4%. It varied significantly by gestational dating method and maternal age. The rates for women aged younger than 35 years and 35 years and older were 62,4% and 94.0%, respectively. The detection rates were 81,3% for ultrasound-dated pregnancies and 67,5% for last menstrual period–dated pregnancies. For Turner syndrome, trisomy 18, triploidy, and trisomy 13, the detection rates were 79,4%, 82,5%, 98,1%, and 36,0%, respectively. The positive rate for Down syndrome was 5,4%. Of women with a Down syndrome fetus who were screen positive, only 49,5% opted for amniocentesis. Of women who obtained results from amniocentesis indicating a Down syndrome fetus, 61,4% had an elective termination, 26,2% had a live birth, 4,5% had a death or miscarriage, and 7,9% had an unknown outcome.

The observed performance of this large triple-marker screening program exceeds generally predicted detection rates for Down syndrome. This study methodology will be used to measure the performance of subsequent screening enhancements. 

References

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Published

2014-07-11

How to Cite

Kazerouni, N. N., Currier, B., Malm, L., Riggle, S., Hodgkinson, C., Smith, S., Tempelis, C., Lorey, F., Davis, A., Jelliffe-Pawlowski, L., Walton-Haynes, L., & Roberson, M. (2014). Triple-marker prenatal screening program for chromosomal defects. REPRODUCTIVE ENDOCRINOLOGY, (16), 84–90. https://doi.org/10.18370/2309-4117.2014.16.84-90

Issue

Section

Laboratory diagnosis