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Article: Ethnicity and the need for correction of biochemical and ultrasound markers of chromosomal anomalies in the first trimester: A study of Oriental, Asian and Afro-Caribbean populations

TitleEthnicity and the need for correction of biochemical and ultrasound markers of chromosomal anomalies in the first trimester: A study of Oriental, Asian and Afro-Caribbean populations
Authors
KeywordsDown syndrome
Free β-hCG
Nuchal translucency
PAPP-A
Prenatal screening
Trisomy 21
Issue Date2005
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/2252
Citation
Prenatal Diagnosis, 2005, v. 25 n. 5, p. 365-369 How to Cite?
AbstractObjectives: To assess whether there is a need to correct first-trimester biochemical markers (free β-hCG and pregnancy-associated plasma protein-A (PAPP-A)) or first-trimester fetal nuchal translucency thickness (NT) in different ethnic groups, when screening for Downs syndrome at 11-14 weeks of gestation. Methods: Free β-hCG, PAPP-A and fetal NT were measured at 11-14 weeks of gestation in a group of women presenting for first-trimester screening in two OSCAR centres. The group comprised 61 219 sets of data from Caucasian women (the reference group); 4835 sets of data from South Asian women; 3450 sets of data from Oriental women and 2727 sets of data from Afro-Caribbean women. The Oriental data set was supplemented with a further 480 cases collected in Hong Kong and the Afro-Caribbean data set was supplemented with 216 cases collected from Kings College. The difference in marker values between the reference group and the other ethnic groups was compared before and after weight correction for the biochemical markers using standard statistical techniques. A correction factor for ethnic origin was applied for all three markers and the screen-positive rate before and after correction was assessed for the various groups. Results: After maternal weight correction, in Afro-Caribbean women, the median PAPP-A was increased by 55% and the free β-hCG increased by 11%. In south Asian women, the PAPP-A was increased by 8% and the free β-hCG decreased by 7.5%. In Oriental women, the PAPP-A was increased by 9% and the free β-hCG by 6%. For delta NT in Afro-Caribbean women, the values were 0.064 mm lower on average than in Caucasian women and for south Asian women 0.045 mm lower. The difference of -0.012 for Oriental women was not significant. Before correcting for ethnic origin, these changes resulted in the screen-positive rates being lower in the Afro-Caribbean group (3.7% vs 5.6%), the south Asian group (4.3% vs 5.6%) and Oriental group (4.9% vs 5.6%). After correction, the screen-positive rates were largely similar in the four groups. Conclusion: Differences in median PAPP-A, free β-hCG and, to a lesser extent, in NT exist in Afro-Caribbean, South Asian and Oriental women. In populations where the medians and delta NT reference ranges are established in predominantly Caucasian populations, some correction for ethnicity is appropriate and can redress differences in screen-positive rates between these different groups. Copyright © 2005 John Wiley & Sons, Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/87234
ISSN
2015 Impact Factor: 3.043
2015 SCImago Journal Rankings: 1.450
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSpencer, Ken_HK
dc.contributor.authorHeath, Ven_HK
dc.contributor.authorElSheikhah, Aen_HK
dc.contributor.authorOng, CYTen_HK
dc.contributor.authorNicolaides, KHen_HK
dc.date.accessioned2010-09-06T09:27:03Z-
dc.date.available2010-09-06T09:27:03Z-
dc.date.issued2005en_HK
dc.identifier.citationPrenatal Diagnosis, 2005, v. 25 n. 5, p. 365-369en_HK
dc.identifier.issn0197-3851en_HK
dc.identifier.urihttp://hdl.handle.net/10722/87234-
dc.description.abstractObjectives: To assess whether there is a need to correct first-trimester biochemical markers (free β-hCG and pregnancy-associated plasma protein-A (PAPP-A)) or first-trimester fetal nuchal translucency thickness (NT) in different ethnic groups, when screening for Downs syndrome at 11-14 weeks of gestation. Methods: Free β-hCG, PAPP-A and fetal NT were measured at 11-14 weeks of gestation in a group of women presenting for first-trimester screening in two OSCAR centres. The group comprised 61 219 sets of data from Caucasian women (the reference group); 4835 sets of data from South Asian women; 3450 sets of data from Oriental women and 2727 sets of data from Afro-Caribbean women. The Oriental data set was supplemented with a further 480 cases collected in Hong Kong and the Afro-Caribbean data set was supplemented with 216 cases collected from Kings College. The difference in marker values between the reference group and the other ethnic groups was compared before and after weight correction for the biochemical markers using standard statistical techniques. A correction factor for ethnic origin was applied for all three markers and the screen-positive rate before and after correction was assessed for the various groups. Results: After maternal weight correction, in Afro-Caribbean women, the median PAPP-A was increased by 55% and the free β-hCG increased by 11%. In south Asian women, the PAPP-A was increased by 8% and the free β-hCG decreased by 7.5%. In Oriental women, the PAPP-A was increased by 9% and the free β-hCG by 6%. For delta NT in Afro-Caribbean women, the values were 0.064 mm lower on average than in Caucasian women and for south Asian women 0.045 mm lower. The difference of -0.012 for Oriental women was not significant. Before correcting for ethnic origin, these changes resulted in the screen-positive rates being lower in the Afro-Caribbean group (3.7% vs 5.6%), the south Asian group (4.3% vs 5.6%) and Oriental group (4.9% vs 5.6%). After correction, the screen-positive rates were largely similar in the four groups. Conclusion: Differences in median PAPP-A, free β-hCG and, to a lesser extent, in NT exist in Afro-Caribbean, South Asian and Oriental women. In populations where the medians and delta NT reference ranges are established in predominantly Caucasian populations, some correction for ethnicity is appropriate and can redress differences in screen-positive rates between these different groups. Copyright © 2005 John Wiley & Sons, Ltd.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/2252en_HK
dc.relation.ispartofPrenatal Diagnosisen_HK
dc.rightsPrenatal Diagnosis. Copyright © John Wiley & Sons Ltd.en_HK
dc.subjectDown syndromeen_HK
dc.subjectFree β-hCGen_HK
dc.subjectNuchal translucencyen_HK
dc.subjectPAPP-Aen_HK
dc.subjectPrenatal screeningen_HK
dc.subjectTrisomy 21en_HK
dc.titleEthnicity and the need for correction of biochemical and ultrasound markers of chromosomal anomalies in the first trimester: A study of Oriental, Asian and Afro-Caribbean populationsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0197-3851&volume=25&spage=365&epage=369&date=2005&atitle=Ethnicity+and+the+need+for+correction+of+biochemical+and+ultrasound+markers+of+chromosomal+anomalies+in+the+first+trimester:+a+study+of+Oriental,+Asian+and+Afro-Caribbean+populations+en_HK
dc.identifier.emailOng, CYT:cytong@hkucc.hku.hken_HK
dc.identifier.authorityOng, CYT=rp00482en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/pd.1153en_HK
dc.identifier.pmid15906426-
dc.identifier.scopuseid_2-s2.0-20444490645en_HK
dc.identifier.hkuros99629en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-20444490645&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume25en_HK
dc.identifier.issue5en_HK
dc.identifier.spage365en_HK
dc.identifier.epage369en_HK
dc.identifier.isiWOS:000229517700006-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridSpencer, K=7202053140en_HK
dc.identifier.scopusauthoridHeath, V=7004279928en_HK
dc.identifier.scopusauthoridElSheikhah, A=6507011688en_HK
dc.identifier.scopusauthoridOng, CYT=7401968192en_HK
dc.identifier.scopusauthoridNicolaides, KH=7203078780en_HK

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