[Establishment of medians for maternal serum markers in Down's syndrome screening during the second trimester of pregnancy in north-central region of Jiangxi Province]

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Jul 28;42(7):831-835. doi: 10.11817/j.issn.1672-7347.2017.07.015.
[Article in Chinese]

Abstract

To establish the median databases of serum markers for Down's syndrome screening during the second trimester of pregnancy women in the north-central area of Jiangxi Province. Methods: Time-resolved fluorometry was used to detect the serum contents of AFP free β-hCG and uE3 in 57 548 pregnant women during 15-20 gestational weeks. Risk evaluation was conducted by LifeCycle 4.0. SAS 9.2 software was used to establish a model of the median fitted equation. The newly constructed median system was used to reassess the risk of Down's syndrome development in pregnant women. Results: The medianand built in medianof north-central region in Jiangxi Province are significantly different (Z=2.201, P=0.028). The relationship between the median of the triple index and the gestational age was analyzed by the weight regression model. The relationship between the MoM value and the weight was used to calculate the reciprocal model. The median of the new system was more efficiency than the built in median. In the median of the new system than the reference, the detection rate improved from 62.75% to 72.55%, false positive rate reduced by 5.84% to 4.94%. Conclusion: The newly constructed median system is suitable for Down's syndrome screening in the north-central region of Jiangxi Province.

目的:建立江西省中北部地区孕中期唐氏综合征(Down’s syndrome,DS)产前筛查血清学标志物中位数数据库。方法:采用时间分辨免疫荧光法对57 548例孕15~20+6周孕妇进行甲胎蛋白(AFP)、游离绒毛膜促性腺激素(β-hCG)和游离雌三醇(uE3)血清学三联筛查,应用LifeCycle 4.0软件进行风险评估。使用SAS 9.2软件进行模型筛选,构建江西省中北部地区孕中期DS筛查人群中位数拟合方程,采用新构建的中位数系统重新评估人群患DS风险,并评估其适用性。结果:江西省中北部地区中位数与内置中位数分布不同,差异有统计学意义(Z=2.201,P=0.028),经模型筛选,三联指标中位数与孕龄的关系采用加权回归模型拟合,三联指标中位数倍数(MoM值)与体重的关系采用倒数模型,拟合效果好;新构建的中位数系统较内置系统检出率由62.75%提高到72.55%,假阳性率由5.84%降低至4.94%。结论:新构建的江西省中北部地区孕中期中位数系统适用于本地区筛查,各地区应建立自己的血清标志物中位数系统以提高筛查效率。.

MeSH terms

  • Biomarkers / blood*
  • Chorionic Gonadotropin, beta Subunit, Human / analysis*
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Down Syndrome / blood
  • Down Syndrome / diagnosis*
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Trimester, Second*
  • Prenatal Diagnosis*

Substances

  • Biomarkers
  • Chorionic Gonadotropin, beta Subunit, Human