Fetal heart size measurements as new predictors of homozygous α-thalassemia-1 in mid-pregnancy.

Abstract:

OBJECTIVE:To evaluate the efficacy of using fetal heart size measurements derived from axial echocardiography to predict homozygous α-thalassemia-1. DESIGN:Prospective diagnostic study. SETTING:The carrier rate of α-thalassemia-1 (-/αα) in China's Guangxi Zhuang Autonomous Region is approximately 15%. If both parents are carriers, the risk of homozygous α-thalassemia-1 in one pregnancy is 25%. PATIENTS:Singleton mid-pregnancies at risk of homozygous α-thalassemia-1 were enrolled. OUTCOME MEASURES:Fetal heart measurements, including heart diameter (HD), heart length (HL), heart circumference (HC), and heart area (HA), were measured. The z-scores for these heart parameters were then calculated separately based on previously constructed z-score models. Finally, the accuracy of these predictive variables was analyzed and compared to that achieved by cardiothoracic ratio (CTR) using a receiver operating characteristic (ROC) curves analysis. RESULTS:A total of 214 singleton pregnancies were recruited. The discriminatory power of HA and HD z-scores was better (z-test P< .01) while that of HC and HL z-scores was comparable to (z-test P>.05) that of CTR. HD combined with HA z-scores had the highest sensitivity (100%), and the specificity of HD and/or HA z-scores was 100%. CONCLUSION:Fetal heart size measurements are novel, effective and noninvasive predictors of homozygosity for α-thalassemia-1 in mid-pregnancy. The discriminatory power of HD and HA z-scores was better than while that of HC and HL z-scores was comparable to that of CTR. Further investigation is needed to understand the effectiveness of these predictors.

journal_name

Congenit Heart Dis

journal_title

Congenital heart disease

authors

Li X,Qiu X,Huang H,Zhao Y,Li X,Li M,Tian X

doi

10.1111/chd.12568

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

282-287

issue

2

eissn

1747-079X

issn

1747-0803

journal_volume

13

pub_type

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