Evaluation of second trimester maternal serum screening for Down’s Syndrome using the Spiegelhalter-Knill-Jones (S-KJ) approach
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Hsiao-Lin Hwa
Abstract
Aims: Risk estimation for Down’s syndrome in antenatal serum screening with maternal age and multiple serum biomarkers is usually complicated and computationally intensive. We have developed a simple scoring system using the Spiegelhalter-Knill-Jones approach, which was based on Bayesian theorem and the logistic regression model.
Methods: A prospective data set with 3842 singleton pregnancies including 6 affected pregnancies served as “trained data”. Maternal age, maternal serum alpha-fetoprotein and human chorionic gonadotrophin levels of each pregnant woman were adopted as the predictors to establish the scoring model using the S-KJ approach. Model validation was undertaken using a receiver operating characteristics (ROC) curve with another 3050 singleton pregnancies including 4 affected pregnancies (“validated data”).
Results: For the trained data the sensitivity and specificity of the scoring system at cut-off value of 1:250 was 66.7% and 92.6%, respectively. For the validated data the sensitivity and specificity at the same cut-off point was 75% and 92.2%, respectively. The area under the ROC curve of the trained and validated data was 76.96% (95% CI: 51.80–100%), and 94.07% (95% CI: 84.47–100%), respectively.
Conclusions: The S-KJ scoring system has been demonstrated to be a simple, and efficient method for the risk estimation of Down’s syndrome. This system can be applied to other antenatal serum screening systems.
References
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Articles in the same Issue
- Fetal membrane inflammatory cytokines: a switching mechanism between the preterm premature rupture of the membranes and preterm labor pathways
- Preeclampsia – abnormal uterine artery Doppler is related to recurrence of symptoms during the next pregnancy
- Mother-to-infant vertical transmission of transfusion transmitted virus in South China
- Evaluation of second trimester maternal serum screening for Down’s Syndrome using the Spiegelhalter-Knill-Jones (S-KJ) approach
- β2-adrenergic receptor gene polymorphisms and pregnancy outcome
- Maternal and fetal insulin-like growth factors 1 and 2 (IGF-1, IGF-2) and IGF BP-3, and their relationship to fetal acidosis at delivery
- Comparison of intrapartum fetal heart rate tracings in patients with neonatal seizures vs. no seizures: what are the differences?
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- The effect of processing and cryopreservation on nucleated umbilical cord blood cells
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- Characterisation of the cytokine inflammatory response in LPS stimulated full-term cord blood
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- Massive hepatic infarction in preeclampsia: successful treatment with continuous hemodiafiltration and corticosteroid therapy
- The use of recombinant factor VIIa in a primigravida with Glanzmann’s thrombasthenia during delivery
- Potential harm from puncture resistant surgical gloves