ESTIMATING A WOMANS RISK OF HAVING A PREGNANCY ASSOCIATED WITH DOWNS-SYNDROME USING HER AGE AND SERUM ALPHA-FETOPROTEIN LEVEL
ESTIMATING A WOMANS RISK OF HAVING A PREGNANCY ASSOCIATED WITH DOWNS-SYNDROME USING HER AGE AND SERUM ALPHA-FETOPROTEIN LEVEL
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DOI：
10.1111/j.1471-0528.1987.tb03115.x
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发表时间：
1987-05-01
期刊：
影响因子：
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通讯作者：
THOMPSON, SG
中科院分区：
文献类型：
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作者：
CUCKLE, HS;WALD, NJ;THOMPSON, SG
根据孕妇的年龄和孕14-20周时血清甲胎蛋白（AFP）水平，估计孕妇发生唐氏综合征的风险。这些估计是使用已发表的数据进行的，这些数据涉及4528例受影响和500多万例未受影响的孕妇的唐氏综合征风险与母亲年龄的关系，以及68例受影响和36645例未受影响的孕妇的血清AFP风险。使用胎龄，基于（i）自上次月经第一天以来的时间和（ii）超声双顶径测量，推导出AFP水平的单独估计值。在每种情况下，这是在考虑到母亲体重的情况下调整和不调整AFP水平的情况下进行的。同样的数据来源也被用来构建六个唐氏综合征筛查政策，每一个都结合了母亲年龄和血清AFP的信息。例如，采用一种政策，检测率为28%，需要选择2.8%的未受影响的妊娠进行子宫内膜穿刺术;仅使用年龄，只有选择4.3%的未受影响的妊娠进行子宫内膜穿刺术才能实现相同的检测率，增加50%。一般来说，使用母亲年龄和血清AFP筛查唐氏综合征比单独使用更有效。
The risk of an individual woman having a pregnancy associated with Down''s syndrome was estimated from her age and her serum alpha-fetoprotein (AFP) level at 14-20 weeks gestation. The estimates were made using published data on the risk of Down''s syndrome in relation to maternal age from 4528 affected and over 5 million unaffeced pregnancies, and on the risk in relation to serum AFP from 68 affected and 36 645 unaffected pregnancies. Separate estimates were derived for AFP levels using gestational age based (i) on the time since the first day of the last menstrual period and (ii) on an ultrasound biparietal diameter measurement. In each case this was done with and without adjusting AFP levels to take account of maternal weight. The same sources of data were also used to construct six Down''s syndrome screening policies, each combining information on maternal age and serum AFP. For example with one policy the detection rate would be 28% and would involve selecting 2.8% of unaffected pregnancies for amniocentesis; using age alone the same detection rate could only be achieved by selecting 4.3% of unaffected pregnancies for amniocentesis.sbd.an increase of 50%. In general, screening for Down''s syndrome using both maternal age and serum AFP is more efficient than either alone.