Effectiveness of ovarian age as the background risk for aneuploidy screening in an unselected pregnant population

REPRODUCTIVE BIOMEDICINE ONLINE

卷:33

Article

Grande, Maribel¹  Sabria, Joan²  Borobio, Virginia¹  Mercade, Immaculada³  Stergiotou, Iosifina¹  Masoller, Narcis¹  Borrell, Antoni¹ 

[1] Hosp Clin Barcelona, Inst Gynecol Obstet & Neonatol, Dept Maternal Fetal Med, BCNatal, Catalonia, Spain

[2] Hosp St Joan de Deu, Dept Obstet & Gynecol, BCNatal, Esplugas de Llobregat, Catalonia, Spain

[3] Hosp Clin Barcelona, CDB, Dept Biochem & Mol Genet, Catalonia, Spain

关键词: anti-Mullerian hormone (AMH);    antral follicle count (AFC);    first trimester combined screening;    trisomy 21;   

DOI  :  10.1016/j.rbmo.2016.07.006

来源: Elsevier

【 摘 要 】

The aim of this study was to assess the performance of first-trimester combined screening when replacing the chronological maternal age by Anti-Mullerian hormo(AMH) and antral follicle count (AFC)-derived ovarian ages, as the background risk in trisomy risk estimation. A total of 639 pregnant women who completed first-trimester combined screening together with AMH and AFC determination were included. Trisomy risks were estimated based on three distinct 'maternal ages' as a-priori risk (chronological age, AMH-and AFC-derived ovarian age). The screening performance was assessed using three different approaches: received operator curve; detection rate and false positive rates for a fixed 1/250 threshold; and detection rates for a fixed 3% false positive rate. A non-significant trend was shown for AMH-derived age for both an increased area under the curve (0.986 versus 0.979) and an increased detection rate (from 83% to 100%) for a 1/250 risk threshold. For a 3% false-positive rate, a non-significant trend for increased detection with the use of both AMH- and AFC-derived ovarian ages was observed (from 67% to 83%). These results indicate that, although ovarian derived ages seem to potentially reflect a more precise background risk for fetal trisomies, the improvement in screening performance is only residual. (C) 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

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