scholarly journals The effect of maternal alcohol and drug abuse on first trimester screening analytes: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anni Lehikoinen ◽  
Raimo Voutilainen ◽  
Jarkko Romppanen ◽  
Seppo Heinonen
Keyword(s):  
Protein A ◽  
Serum Levels ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Maternal Serum ◽  
Drug Abusers ◽  
Alcohol Abusers ◽  
Trimester Screening ◽  
Alcohol And Drug Abuse ◽  
Β Hcg

Abstract Background The purpose of this study was to determine whether first trimester trisomy screening (FTS) parameters are affected by alcohol and drug use. Methods A routine combined FTS including measurements of maternal serum levels of free β-human chorionic gonadotropin subunit (free β-hCG) and pregnancy-associated plasma protein A (PAPP-A) were measured at 9–11 weeks of gestation, and fetal nuchal translucency thickness (NTT) at 11–13 weeks of gestation. In total 544 women with singleton pregnancies [71 alcohol and drug abusers, 88 smokers, 168 non-smokers delivering a small for gestational age (SGA) child, and 217 unexposed control women] were assessed. Results Free β-hCG levels were higher in alcohol and drug abusing than in unexposed pregnant women [mean 1.5 vs. 1.2 multiples of medians (MoM); P = 0.013]. However, stepwise multiple linear regression analyses suggested that smoking could explain increased free β-hCG. Additionally, we observed lower PAPP-A levels in the smoking mothers (0.9 vs. 1.2 MoM; P = 0.045) and in those giving birth to an SGA child compared to the controls (1.1 vs.. 1.2 MoM; P < 0.001). Fetal NTT did not differ significantly between any of the groups. Conclusions The present study shows increased free β-hCG levels in alcohol and drug abusers, but maternal smoking may explain the result. Maternal serum PAPP-A levels were lower in smoking than non-smoking mothers, and in mothers delivering an SGA child. However, FTS parameters (PAPP-A, free β-hCG and NTT) seem not to be applicable for the use as alcohol biomarkers because of their clear overlap between alcohol abusers and healthy controls.

First trimester Down's syndrome screening marker values and cigarette smoking: new data and a meta-analysis on free β human chorionic gonadotophin, pregnancy-associated plasma protein-A and nuchal translucency

2008 ◽  
Vol 15 (4) ◽  
pp. 204-206 ◽  
Author(s):  
Jonathan P Bestwick ◽  
Wayne J Huttly ◽  
Nicholas J Wald
Keyword(s):  
Meta Analysis ◽  
False Positive Rate ◽  
Protein A ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Screening Performance ◽  
Combined Test ◽  
Positive Rate ◽  
Trimester Screening ◽  
Β Hcg

Objectives To examine the effect of smoking on three first trimester screening markers for Down's syndrome that constitute the Combined test, namely nuchal translucency (NT), pregnancy-associated plasma protein-A (PAPP-A) and free β human chorionic gonadotophin (free β-hCG) and to use the results to determine which of these markers need to be adjusted for smoking and by how much. Methods The difference in the median multiple of the median (MoM) values in smokers compared to non-smokers was determined for NT, PAPP-A and free β-hCG in 12,517 unaffected pregnancies that had routine first trimester Combined test screening. These results were then included in a meta-analysis of published studies and the effect of adjusting for smoking on screening performance of the Combined test was estimated. Results The results using the routine screening data were similar to the summary estimates from the meta-analysis of all studies. The results from the meta-analysis were; median MoM in smokers compared to non-smokers: 1.06 NT (95% confidence interval 1.03 to 1.10), 0.81 PAPP-A (0.80 to 0.83) and 0.94 free β-hCG (0.89 to 0.99). The effect of adjusting for smoking on the Combined test is small, with an estimated less than half percentage point increase in the detection rate (the proportion of affected pregnancies with a positive result) for a 3% false-positive rate (the proportion of unaffected pregnancies with a positive result) and less than 0.2 percentage point decrease in the false-positive rate for an 85% detection rate. Conclusion Adjusting first trimester screening markers for smoking has a minimal favourable effect on screening performance, but it is simple to implement and this paper provides the adjustment factors needed if a decision is made to make such an adjustment.

REFERENCE CENTILE CHARTS OF PAPP-AAND FREE β-HCG IN INDIAN PREGNANT WOMEN.

2021 ◽  
pp. 14-16
Author(s):  
Ankur Jindal ◽  
Anupa Prasad ◽  
Sunil Kumar Polipalli
Keyword(s):  
Protein A ◽  
Nuchal Translucency ◽  
Fetal Outcome ◽  
Maternal Serum ◽  
Weak Correlation ◽  
Normal Range ◽  
Crown Rump Length ◽  
Trimester Screening ◽  
Β Hcg ◽  
The Individual

The combined rst-trimester screening (CFTS) for fetal aneuploidy involves a combination of maternal age, fetal nuchal translucency (NT), maternal serum pregnancy-associated plasma protein-A(PAPP-A) and free β-human chorionic gonadotropin (β-hCG) from 11+0 to 13+6 weeks of gestation [1]. International prescriptive standards for early fetal linear size and ultrasound dating of pregnancy in the rst trimester are available and used throughout the world. Ethnicity has an effect on the biochemical parameters of rst trimester screening. As there is a lack of reference chart for the women of Indian ethnicity, we aimed to nd out the level of PAPP-Aand free β-hCG for fetal crown rump length (CRL) of 40-84 mm in the rst trimester of pregnancy and construct the centile charts for both the parameters. Asignicant but weak correlation between the individual models of PAPP-A and β-hCG and CRL (P<0.001). In conclusion, the normal range of PAPP-A and free β-hCG depending on the gestation (CRL) was derived in this cohort study. This would act as a reference for our population and would be helpful in calculating the risk of an adverse maternal and fetal outcome.

The influence of different sample collection types on the levels of markers used for Down's syndrome screening as measured by the Kryptor Immunosassay system

2003 ◽  
Vol 40 (2) ◽  
pp. 166-168 ◽  
Author(s):  
Kevin Spencer
Keyword(s):  
Processing Time ◽  
Point Of Care ◽  
Protein A ◽  
First Trimester ◽  
Maternal Serum ◽  
Blood Collection ◽  
Chromosomal Anomalies ◽  
Sample Collection ◽  
Edta Plasma ◽  
Β Hcg

Background: In a rapid point-of-care screening programme for chromosomal anomalies, analysis of biochemical markers in maternal blood can now be accomplished in a rapid time frame (less than 20 min). The need to leave whole blood samples some 10 min for coagulation and a further 5 min for centrifugation adds additional processing time. Methods: The possibilities for reducing this processing time were investigated using various anticoagulated blood collection systems and the Kryptor analytical platform. Plasma levels of α-fetoprotein (AFP), pregnancy-associated plasma protein-A (PAPP-A) and free human chronic gonadotrophin β-subunit (β-hCG) were compared with those in maternal serum. Results: From the mean results from ten patients it was shown that use of heparin plasma resulted in a statistically significant reduction in levels of PAPP-A and that EDTA plasma reduced the levels of PAPP-A dramatically. For AFP, levels in citrated plasma and EDTA plasma were also significantly reduced, whereas levels of free β-hCG were not affected. Conclusion: Use of alternative sample types for PAPP-A is not possible. The sample of choice for first trimester screening using the Kryptor platform is maternal serum.

scholarly journals First-trimester Screening: An Overview

2005 ◽  
Vol 53 (3) ◽  
pp. 281-283 ◽  
Author(s):  
Bernd Eiben ◽  
Ralf Glaubitz
Keyword(s):  
Prenatal Screening ◽  
Heart Defects ◽  
Protein A ◽  
Nasal Bone ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Maternal Blood ◽  
Chromosomal Anomalies ◽  
Detection Rates ◽  
Trimester Screening

An improvement in prenatal screening for chromosomal defects has been achieved by combining sonography and biochemical markers. Analyzing markers taken from maternal blood such as pregnancy-associated plasma protein A and free β-human chorionic gonadotropin in combination with the ultrasound marker nuchal translucency provides detection rates of 90% for the most important chromosomal anomalies. In addition, nuchal translucency is a marker for severe heart defects. This report discusses the potential of new markers such as the nasal bone.

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