Age-based differences in the predictive accuracy of a one-size-fits-all risk-cutoff value in prenatal integrated screening for Down syndrome

Prenat Diagn. 2017 Sep;37(9):894-898. doi: 10.1002/pd.5101. Epub 2017 Jul 25.

Abstract

Objective: The objective of this study is to assess variation in detection and false positive rates and adverse pregnancy outcomes across different age groups when a one-size-fits-all risk-cutoff value, such as 1/270, is used in integrated screening for Down syndrome.

Method: A Monte Carlo simulation was utilized to estimate the detection and false positive rates as well as adverse pregnancy outcomes.

Results: Using a one-size-fits-all risk-cutoff value, such as 1/270, can result in considerably high variations in detection and false positive rates across maternal ages and lead to a higher than the minimum possible total number of adverse outcomes.

Conclusion: Our findings indicate that the one-size-fits-all risk-cutoff value of 1/270, commonly used in DS screening, should be revisited and alternative (possibly age-based) cutoff values and strategies should be considered. © 2017 John Wiley & Sons, Ltd.

MeSH terms

  • Chorionic Gonadotropin / blood
  • Down Syndrome / diagnosis*
  • Estriol / blood
  • False Positive Reactions
  • Female
  • Humans
  • Maternal Age*
  • Monte Carlo Method
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy-Associated Plasma Protein-A / analysis
  • Prenatal Diagnosis / adverse effects
  • Prenatal Diagnosis / methods*
  • Reference Values
  • Risk Factors
  • Ultrasonography, Prenatal
  • alpha-Fetoproteins / analysis

Substances

  • Chorionic Gonadotropin
  • alpha-Fetoproteins
  • Pregnancy-Associated Plasma Protein-A
  • Estriol