First trimester screening cut-offs for noninvasive prenatal testing as a contingent screen: Balancing detection and screen-positive rates for trisomy 21.
Aust N Z J Obstet Gynaecol
; 56(1): 29-35, 2016 Feb.
Article
in En
| MEDLINE
| ID: mdl-26749261
ABSTRACT
OBJECTIVE:
To provide data on how screen-positive and detection rates of first trimester prenatal screening for fetal Down syndrome vary with changes in the risk cut-off and maternal age to inform contingency criteria for publicly funded noninvasive prenatal testing. MATERIALS ANDMETHODS:
First trimester screening and diagnostic data were collected for all women attending for first trimester fetal aneuploidy screening in Western Australia between 2005 and 2009. Prenatal screening and diagnostic data were linked to pregnancy outcomes, including data from the Midwives' Notification System and the Western Australian Registry of Developmental Anomalies. The prevalence of Down syndrome and performance of screening by risk cut-off and/or for women >35 years were analysed.RESULTS:
The current screening risk cut-off of 1300 has screen-positive and detection rates of 3.5% and 82%. The screen-positive rate increases by 0.7-0.8% for each 100 point change in risk, up to 19.2% at 12500 (96% detection rate). Including all women >35 years as screen positive would increase the screen-positive rate and detection rates to 30.2% and 97.2%.CONCLUSION:
Variation in screening risk cut-off and the use of maternal age to assess eligibility for noninvasive testing could significantly impact the demand for, and cost of, the test. A contingent first trimester screening approach for risk assessment is superior to the use of a combination of screening and maternal age alone. These data will inform decisions regarding the criteria used to determine eligibility for publicly funded noninvasive prenatal testing.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pregnancy Trimester, First
/
Ultrasonography, Prenatal
/
Down Syndrome
/
Maternal Serum Screening Tests
/
Clinical Decision-Making
/
Health Policy
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Country/Region as subject:
Oceania
Language:
En
Journal:
Aust N Z J Obstet Gynaecol
Year:
2016
Document type:
Article
Affiliation country:
Australia