924: First trimester early-onset preeclampsia and expanded down syndrome screening: Maternal race/ethnicity adjustments

Preeclampsia is a serious disorder of human pregnancy occurring after 20 weeks of gestation. It can be divided into subtypes of early onset (<34 weeks of gestation) and late onset (>34 weeks). Presymptomatic detection to identify those at high risk is important for managing this disease. HtrA3, a serine protease with high expression in the developing placenta, exists in long (HtrA3-L) and short (HtrA3-S) isoforms. They are identical, except HtrA3-S lacks the C-terminal PDZ domain. We have previously shown by Western blot analysis that serum HtrA3 levels at the end of the first trimester are significantly higher in women who later develop preeclampsia than in controls. In this study, using highly specific HtrA3 monoclonal antibodies, we established and fully validated two enzyme-linked immunosorbent assays to detect both HtrA3 isoforms together (HtrA3-T) and HtrA3-L alone in the human serum. We then determined serum HtrA3 at 11 to 13 weeks of gestation in a cohort of singleton pregnancies that proceeded without complications or developed preeclampsia in the third trimester. Compared with controls, those who developed late-onset preeclampsia had significantly higher levels of HtrA3-L, whereas those who developed early-onset preeclampsia had significantly lower ratios of HtrA3-L/HtrA3-T. These data support a potential utility of these HtrA3 ELISAs for early detection of preeclampsia.

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Gender impact on first trimester markers in Down syndrome screening

Prenatal Diagnosis ◽

10.1002/pd.493 ◽

2002 ◽

Vol 22 (13) ◽

pp. 1207-1208 ◽

Cited By ~ 25

Author(s):

Severin Olesen Larsen ◽

Karen R. Wøjdemann ◽

Anne-Cathrine Shalmi ◽

Karin Sundberg ◽

Michael Christiansen ◽

...

Keyword(s):

Down Syndrome ◽

First Trimester ◽

Down Syndrome Screening

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Uptake of Noninvasive Prenatal Testing in Chinese Women following Positive Down Syndrome Screening

Fetal Diagnosis and Therapy ◽

10.1159/000365811 ◽

2014 ◽

Vol 37 (2) ◽

pp. 141-147 ◽

Cited By ~ 7

Author(s):

C.F. Poon ◽

W.C. Tse ◽

K.O. Kou ◽

K.Y. Leung

Keyword(s):

Down Syndrome ◽

Chinese Women ◽

Multivariable Analysis ◽

Chorionic Villus ◽

Prenatal Testing ◽

First Trimester ◽

Screening Methods ◽

Chorionic Villus Sampling ◽

Noninvasive Prenatal Testing ◽

Down Syndrome Screening

Objectives: To investigate how the introduction of noninvasive prenatal testing (NIPT) influenced women's testing choices following a positive Down syndrome screening. Methods: A retrospective study was conducted to compare differences in the uptake rates of invasive prenatal diagnosis (IPD) or no testing in one public hospital 1 year before (pre-NIPT) and 1 and 2 years after the introduction of NIPT in private in August 2011 using descriptive analysis and a χ2 test. Conventional screening was funded publicly, but NIPT was not. Multivariable binary logistic regression was used to determine factors affecting choices. Results: In pre-NIPT and in years 1 and 2 after the introduction of NIPT, 306, 362 and 401 women who screened positive were seen, respectively. In year 1 and year 2, 12.6 and 26.7% of them underwent NIPT while IPD was decreased by 16.3 and 25.6%, respectively (p < 0.001). Both chorionic villus sampling and amniocentesis decreased in year 1, but only the former in year 2. However, the rate of declining further testing was similar before and after NIPT (p = 0.213). In multivariable analysis, first trimester screening, nulliparity and working women were significant predictors of accepting NIPT, while only nulliparity was a predictor of declining IPD (OR = 0.61). Conclusions: Introduction of NIPT resulted in a significant decrease in IPD for 2 consecutive years.

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