Risk of fetal loss associated with invasive testing following combined first-trimester screening for Down syndrome: a national cohort of 147 987 singleton pregnancies
Risk of fetal loss associated with invasive testing following combined first-trimester screening for Down syndrome: a national cohort of 147 987 singleton pregnancies
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DOI：
10.1002/uog.15820
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发表时间：
2016-01-01
影响因子：
7.1
通讯作者：
Tabor, A.
中科院分区：
文献类型：
--
作者：
Wulff, C. B.;Gerds, T. A.;Tabor, A.
目的前瞻性评估孕早期唐氏综合征联合筛查（cFTS）后绒毛膜绒毛取样（CVS）和绒毛膜穿刺术（AC）相关的胎儿丢失风险。倾向评分分层用于评估有无侵入性检测的胎儿丢失风险。CVS在cFTS后3 - 21天进行分析，AC在cFTS后28 - 42天进行分析。结果报告为平均风险差异和95% CI。结果与分析时间点无关，接触CVS或AC的女性流产和死产的风险并不高于未接触CVS或AC的女性。CVS对流产风险的平均影响为-0.08%（95% CI，-0.64; 0.47），第3天和-0.21%（95% CI，-0.58; 0.15），而对死产风险的影响为-0.18% cFTS后3天为-0.50至0.13，21天为-0.27%至95%CI，-0.58至0.04。关于AC对流产风险的影响，在cFTS后28天的分析显示平均效应为0.56%（95%CI，-0.21; 1.33），而在cFTS后42天对死胎风险的影响为0.09%（95%CI，-0.39; 0.58）。这些结果表明CVS和AC的手术相关风险非常低。Copyright（c）2015 ISUOG.由John Wiley & Sons有限公司出版
Objective To assess prospectively the risk of fetal loss associated with chorionic villus sampling (CVS) and amniocentesis (AC) following combined first-trimester screening (cFTS) for Down syndrome.Methods This was a nationwide population-based study (Danish Fetal Medicine Database, 2008-2010) including 147 987 women with singleton pregnancy who underwent cFTS. Propensity score stratification was used to assess the risk of fetal loss with and without invasive testing. Analyses were performed between 3 and 21 days after cFTS for CVS and between 28 and 42 days after cFTS for AC.Results are reported as average risk differences with 95% CIs. Results The risks of miscarriage and stillbirth were not higher in women exposed to CVS or AC compared with unexposed women, independent of the analysis time-point. The average effect of CVS on risk of miscarriage was -0.08% (95% CI, -0.64; 0.47) at 3 days and -0.21% (95% CI, -0.58; 0.15) at 21 days after cFTS, while the effect on risk of stillbirth was -0.18% (95% CI, -0.50; 0.13) at 3 days and -0.27% (95% CI, -0.58; 0.04) at 21 days after cFTS. Regarding the effect of AC on risk of miscarriage, the analysis at 28 days after cFTS showed an average effect of 0.56% (95% CI, -0.21; 1.33), while the effect on risk of stillbirth was 0.09% (95% CI, -0.39; 0.58) at 42 days after cFTS.Conclusion Neither CVS nor AC was associated with increased risk of miscarriage or stillbirth. These findings indicate that the procedure-related risk of CVS and AC is very low. Copyright (c) 2015 ISUOG. Published by John Wiley & Sons Ltd.