Advanced maternal age as a sole indication for genetic amniocentesis; risk-benefit analysis based on a large database reflecting the current common practice
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Eran Bornstein
Abstract
Aims: Recent advances in prenatal screening, including first and second trimester genetic screening as well as targeted sonography, have significantly improved the detection of trisomy 21. Therefore, several investigators have questioned the validity of recommending genetic amniocentesis to all women who are 35 years or older at delivery. Thus, we sought to investigate the risks and benefits associated with performing genetic amniocentesis in women whose sole indication for testing was advanced maternal age (AMA).
Methods: A retrospective review of a Genzyme Genetics amniocentesis database (January 2006–December 2006) was performed. All specimens obtained from women of AMA as the sole indication were eligible for analysis. The amniocentesis-related potential fetal loss was calculated based on the traditional fetal loss rate of 1/200 as well as the recently published loss rate of 1/1600 procedures. Risk-benefit analysis was performed by comparing the number of trisomy 21 fetuses identified within the AMA group to the potential number of amniocentesis-related fetal losses within this group.
Results: A total of 87,241 amniocentesis specimens were processed during the study period. AMA was the sole indication for genetic amniocentesis in 43,303 cases which formed the study group. In 399 (0.92%) of these cases, a trisomy 21 was identified. Assuming an amniocentesis related fetal loss rates of 1/200 or 1/1600; 217 or 27 fetal losses would have been expected, respectively.
Conclusions: Our analysis suggests that the benefit of genetic amniocentesis for the sole indication of AMA far outweighs the potential amniocentesis-related fetal loss rate, regardless of the actual rate one considers.
©2009 by Walter de Gruyter Berlin New York
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Artikel in diesem Heft
- Selected articles from the 31st scientific meeting of the New York Perinatal Society on May 19, 2008
- Advanced maternal age as a sole indication for genetic amniocentesis; risk-benefit analysis based on a large database reflecting the current common practice
- Risks for common medical conditions experienced by former preterm infants during toddler years
- Predictors of severe perineal lacerations in Chinese women
- Maternal and neonatal outcomes in early glucose tolerance testing in an obstetric population in New York city
- Original articles – Obstetrics
- Prelabor rupture of membranes at term requiring labor induction – a feature of occult fetal cephalopelvic disproportion?
- Group B Streptococcus colonization in pregnancy: prevalence and prevention strategies of neonatal sepsis
- Preterm labor and bacterial vaginosis-associated bacteria among urban women
- Lipopolysaccharide binding protein in the early diagnosis of intraamniotic infection of pregnant women with premature rupture of the membranes
- Perinatal outcomes after second trimester detection of amniotic fluid viral genome in asymptomatic patients
- Is induced abortion a risk factor in subsequent pregnancy?
- An approach to the prediction of neonatal Erb palsy
- External cephalic version among women with a previous cesarean delivery: report on 36 cases and review of the literature
- Original articles – Fetus
- Reference range of fetal lung volume by 3D-ultrasonography using the rotational method (VOCAL)
- Sex differences in linear and complex fetal heart rate dynamics of normal and acidemic fetuses in the minutes preceding delivery
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- Congress Calender
- Congress Calendar
- WAPM-Newsletter 1/2009: Istanbul Declaration on following Ethics in Perinatal Medicine
- WAPM-Newsletter No 1/2009
