hCG and the free beta-subunit as screening tests for Down syndrome.

Abstract:

:Published studies have reached varying conclusions as to the benefit of replacing human chorionic gonadotropin (hCG) measurements with the free beta-subunit of hCG (the free beta-subunit) for Down syndrome screening. One study reports 14 per cent higher detection for the free beta-subunit, while another finds an actual loss in detection. To explore this issue further, we directly compared the screening performance of hCG and the free beta-subunit, alone and in combination with other serum markers, using banked sera obtained prior to amniocentesis and karyotyping. Altogether, 52 Down syndrome and 5065 unaffected pregnancies were studied. Sera were thawed and assayed for hCG and the free beta-subunit over 1 year. At a 5 per cent false-positive rate, the detection rate for hCG in combination with maternal age and alpha-fetoprotein was higher than when the free beta-subunit was substituted (62 versus 57 per cent). Ultrasound dating and adding unconjugated oestriol both increased detection. The present findings, along with those from six case control studies (our re-analysis), indicate that the screening performances of hCG and the free beta-subunit are similar (median change in detection 0, range -8 to +3 per cent). Under optimal sample collection and transportation conditions, laboratories can expect to achieve similar screening performance using either hCG or the free beta-subunit measurements.

journal_name

Prenat Diagn

journal_title

Prenatal diagnosis

authors

Knight GJ,Palomaki GE,Neveux LM,Fodor KK,Haddow JE

subject

Has Abstract

pub_date

1998-03-01 00:00:00

pages

235-45

issue

3

eissn

0197-3851

issn

1097-0223

pii

10.1002/(SICI)1097-0223(199803)18:3<235::AID-PD248

journal_volume

18

pub_type

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