Abstract | OBJECTIVE: DESIGN: Retrospective analysis of prospective combined screening for aneuploidies in singleton pregnancies at 11(+0) -13(+6) weeks of gestation. SETTING: Antenatal clinic. POPULATION: Singleton pregnancies at 11(+0) -13(+6) weeks of gestation resulting in the delivery of phenotypically normal neonates. The study included 194 women with type-1 diabetes, 122 women with type-2 diabetes, 779 women who developed GDM and 41,007 non-diabetic controls. METHODS: Maternal free β-hCG and PAPP-A levels were expressed as multiples of the respective normal median (MoM), and fetal NT was expressed as a difference from the expected median (Δ). MAIN OUTCOME MEASURES: Comparison of median MoM maternal free β-hCG and PAPP-A, and fetal NT, in the four outcome groups. RESULTS: There were no significant differences between the groups in median ΔNT and maternal free β-hCG MoM. Maternal median PAPP-A in type-2 diabetes, compared with the non-diabetic group, was reduced (0.75 MoM, IQR 0.50-1.09 MoM versus 1.00 MoM, IQR 0.68-1.42 MoM; P < 0.001), which resulted in doubling in the false-positive rate in the combined screening in this population. There were no significant differences in maternal PAPP-A between the other groups. CONCLUSIONS: In women with type-2 diabetes, the estimation of accurate patient-specific risk in the first trimester combined screening for aneuploidies necessitates an adjustment of maternal serum PAPP-A.
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Authors | M D Savvidou, A Syngelaki, M Muhaisen, E Emelyanenko, K H Nicolaides |
Journal | BJOG : an international journal of obstetrics and gynaecology
(BJOG)
Vol. 119
Issue 4
Pg. 410-6
(Mar 2012)
ISSN: 1471-0528 [Electronic] England |
PMID | 22324916
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG. |
Chemical References |
- Biomarkers
- Chorionic Gonadotropin, beta Subunit, Human
- Pregnancy-Associated Plasma Protein-A
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Topics |
- Adult
- Biomarkers
(blood)
- Chorionic Gonadotropin, beta Subunit, Human
(blood)
- Diabetes Mellitus, Type 1
(blood, complications)
- Diabetes Mellitus, Type 2
(blood, complications)
- Diabetes, Gestational
(blood)
- Down Syndrome
(diagnosis)
- Female
- Humans
- Mass Screening
- Nuchal Translucency Measurement
- Pregnancy
- Pregnancy Trimester, First
- Pregnancy in Diabetics
(blood)
- Pregnancy-Associated Plasma Protein-A
(metabolism)
- Prospective Studies
- Risk Assessment
- Risk Factors
- Surveys and Questionnaires
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