1
|
Hunsaker JJH, La'ulu SL, LaGrave D, Murphy W, Reichman HA, Snow TM, McMillin GA, Johnson-Davis KL, Genzen JR. Tobacco and Cannabis Use During Pregnancy. Am J Clin Pathol 2022; 157:146-152. [PMID: 34508553 DOI: 10.1093/ajcp/aqab093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/22/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Nicotine (NIC) use during pregnancy can influence markers used in biochemical maternal serum screening. This study was designed to determine prevalence of disclosed tobacco smokers in our patient population and to compare disclosed tobacco smoking status with the presence of serum nicotine and a common tetrahydrocannabinol (THC) metabolite. METHODS A deidentified dataset of disclosed smoking status for quadruple (Quad) screens was obtained. Residual serum submitted for Quad screens was obtained from frozen storage and analyzed for NIC and THC metabolites. RESULTS Of specimens that had corresponding responses to the smoking history question on the patient history form, 7.2% (n = 1,783 of 24,611) specified that the patient was a tobacco smoker. Of the 271 specimens biochemically analyzed for NIC and THC metabolites, disclosed tobacco smokers had the highest prevalence of detectable NIC and THC metabolites. THC product use was most prevalent in patients categorized as probable tobacco smokers based on cotinine concentrations, as well as in younger patients. CONCLUSIONS Prevalence and concentration of NIC and THC metabolites vary based on disclosed tobacco smoker status. Biochemical testing may increase sensitivity for the identification of NIC and THC status over self-reporting.
Collapse
Affiliation(s)
- Joshua J H Hunsaker
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
| | - Sonia L La'ulu
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
| | | | | | | | - Taylor M Snow
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
| | - Gwendolyn A McMillin
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
- ARUP Laboratories, Salt Lake City, UT, USA
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kamisha L Johnson-Davis
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
- ARUP Laboratories, Salt Lake City, UT, USA
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jonathan R Genzen
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
- ARUP Laboratories, Salt Lake City, UT, USA
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
| |
Collapse
|
2
|
Lambert-Messerlian G, Palomaki GE. Prenatal serum screening markers may not require adjustment in former smokers. Prenat Diagn 2015; 35:1371-3. [PMID: 26413989 DOI: 10.1002/pd.4695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/08/2015] [Accepted: 09/20/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Geralyn Lambert-Messerlian
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital and Alpert Medical School of Brown University, Providence, RI, USA
| | - Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital and Alpert Medical School of Brown University, Providence, RI, USA
| |
Collapse
|
3
|
Jauniaux E, Suri S, Muttukrishna S. Evaluation of the impact of maternal smoking on ultrasound and endocrinological markers of first trimester placentation. Early Hum Dev 2013; 89:777-80. [PMID: 23845775 DOI: 10.1016/j.earlhumdev.2013.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 05/25/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To study the effect of maternal smoking on 2D ultrasound measurements and maternal serum (MS) levels of endocrinologic markers of placentation. STUDY DESIGN Prospective population-based cohort study of 32 smokers and 96 non-smoking controls with a normal pregnancy outcome. MAIN OUTCOME MEASURES Placental thickness and 2D-volume and MS levels of pregnancy-associated plasma protein A (PAPP-A) and free-beta human chorionic gonadotrophin (fβhCG) at 11-13(+6)weeks of gestation and mid-trimester MS α-fetoprotein (AFP), unconjugated estriol (uE3) and inhibin A levels. RESULTS The MS levels of fβhCG and PAPP-A were significantly (P < 0.01 and P < 0.001, respectively) lower in the serum and the level of inhibin A significantly (P < 0.001) higher in the smokers than in controls. There was no significant difference for the MSAFP, MSuE3 placental thickness, basal plate surface and volume between the groups. CONCLUSION The placental morphological alterations secondary to maternal smoking are mainly at the level of the villous trophoblast and are not associated with changes in the placental size or utero-placental interface during the first trimester of pregnancy.
Collapse
Affiliation(s)
- E Jauniaux
- UCL EGA Institute for Women's Health, University College London, London, United Kingdom
| | | | | |
Collapse
|
4
|
Cowans NJ, Spencer K. First trimester maternal serum inhibin A concentrations in smokers. Prenat Diagn 2013; 33:296-7. [PMID: 23354772 DOI: 10.1002/pd.4050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Nicholas J Cowans
- Prenatal Research Unit, Department of Clinical Biochemistry, King George Hospital, Barley Lane, Goodmayes, IG3 8YB, UK.
| | | |
Collapse
|
5
|
Lepage N, Chaudhry A, Konforte D, Shaw J, Veljkovic K, Dennis A, Rashid S, Farrell SA. Standardized Procedural Practices of the Ontario Prenatal Screening Program for aneuploidies and open neural tube defects. Clin Biochem 2012; 45:1152-7. [PMID: 22732525 DOI: 10.1016/j.clinbiochem.2012.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 06/13/2012] [Accepted: 06/14/2012] [Indexed: 01/23/2023]
Abstract
BACKGROUND/OBJECTIVES The Ontario Prenatal Screening Program (OPSP) follows internationally recognized standardized procedures for laboratories and genetics clinics. However, it has been found that some procedures are subject to interpretation, so the current procedures are designed to facilitate a unified approach in the interpretation of literature recommendations. In Ontario, the OPSP offers multiple screening modalities with integrated prenatal screening (including both first and second trimester markers) being the most commonly chosen option. Other screening modalities include first trimester screening, second trimester quad screening, serum integrated screening, and NT-Quad. METHODS The standardization was based on a literature review and on current practices in Ontario. RESULTS/DISCUSSION The main finding of the review was a paucity of published data relating to the procedures and the decision-making processes involved in prenatal screening. The purpose of this publication is to provide the most up-to-date and pertinent information for clinical laboratory professionals involved with prenatal screening for Down syndrome, trisomy 18 and open neural tube defects.
Collapse
Affiliation(s)
- Nathalie Lepage
- Department of Pathology and Laboratory Medicine, University of Ottawa and Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
| | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Cuckle HS. Screening for pre-eclampsia--lessons from aneuploidy screening. Placenta 2011; 32 Suppl:S42-8. [PMID: 21257082 DOI: 10.1016/j.placenta.2010.07.015] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 07/26/2010] [Accepted: 07/28/2010] [Indexed: 01/14/2023]
Abstract
BACKGROUND Antenatal screening for aneuploidy is an established routine clinical practice worldwide. The same statistical methodology, developed and refined over three decades, might be adapted to screening for pre-eclampsia. METHODS The published literature is reviewed for evidence that the methodology is valid for pre-eclampsia using first trimester maternal serum PP13, PAPP-A, PlGF, ADAM12 and inhibin A, together with MAP and uterine artery Doppler PI. Risk is estimated for both early onset pre-eclampsia, requiring delivery before 34 weeks, or late onset disease. Prior risk from the background prevalence multiplied by likelihood ratios (LRs) for ethnicity, parity, adiposity and family history is multiplied by an LR from the screening marker profile. Markers are expressed in multiples of the gestation-specific median and adjusted for body mass, ethnicity and smoking status as appropriate. A standardized population with a fixed distribution of risk factors and a multi-variate Gaussian model of marker profiles is used to predict performance. RESULTS There is sufficient published data to estimate individual risks reasonably well. Modeling predicts that using PAPP-A and one other serum marker, together with the physical markers more than two-thirds of early and one-third of late onset cases can be detected by classifying less than 2% of pregnancies as high risk; three-quarters of early case could be detected with a 5% high risk rate. CONCLUSION Whilst more data on some markers is still required modeling so far suggests that extending first trimester aneuploidy screening programs to include pre-eclampsia screening would yield a high detection. However, prospective studies are needed to verify the model predictions.
Collapse
Affiliation(s)
- H S Cuckle
- Department of Obsterics and Gynecology, Columbia University Medical Center, 622 W. 168th Street, PH1666, New York, NY 10032, USA.
| |
Collapse
|
7
|
Zhang J, Lambert-Messerlian G, Palomaki GE, Canick JA. Impact of smoking on maternal serum markers and prenatal screening in the first and second trimesters. Prenat Diagn 2011; 31:583-8. [DOI: 10.1002/pd.2755] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 02/28/2011] [Accepted: 03/01/2011] [Indexed: 11/05/2022]
|
8
|
Bersinger N, Baumann M. Serum markers for pre-eclampsia: An update on the analytes to be determined in the first, second, and third trimester. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.immbio.2009.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
9
|
Miron P, Côté YP, Lambert J. Effect of maternal smoking on prenatal screening for Down syndrome and trisomy 18 in the first trimester of pregnancy. Prenat Diagn 2008; 28:180-5. [DOI: 10.1002/pd.1930] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
10
|
Maymon R, Cuckle H, Herman A. Maternal serum inhibin levels in twin and singleton pregnancies conceived by assisted reproduction. Hum Reprod 2006; 21:1305-8. [PMID: 16501040 DOI: 10.1093/humrep/dei492] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To investigate whether second trimester serum inhibin levels differ in pregnancies conceived by assisted reproduction technology (ART). METHODS In Israel, serum samples from twin pregnancies were obtained for inhibin testing from women either referred for routine ultrasound monitoring, follow up after multi-fetal reduction or amniocentesis, largely for advanced maternal age. In the UK, inhibin had been tested prospectively in singleton and twin pregnancies of women having routine Down's syndrome (DS) screening. Results were available from 207 ART pregnancies: 170 singletons and 37 twins. This includes 15 twins from Israel, known to have been reduced from triplets to twins. Comparison was made with 4384 spontaneous pregnancies: 4334 singletons and 50 twins. Results were expressed in multiples of the gestation-specific median (MoM) for normal spontaneous pregnancies. RESULTS In ART singletons, the median maternal inhibin level was higher (1.11 MoM) than in spontaneous singletons (0.99 MoM, P < 0.001, two-tail Wilcoxon Rank Sum Test). In twins, there was no material difference between ART and spontaneous pregnancies with medians of 1.98 and 2.18 MoM, respectively (P = 0.62). There was no effect of multi-fetal reduction, with medians of 1.76 and 1.81 MoM in reduced and non-reduced twins, respectively (P = 0.46). CONCLUSION It appears that serum inhibin levels are increased on average in ART singletons but not in ART twin pregnancies. More data will be needed before deciding whether risk calculation parameters need to be altered when using inhibin for DS screening in pregnancy.
Collapse
Affiliation(s)
- Ron Maymon
- Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin and Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | | | | |
Collapse
|
11
|
Abstract
This article provides clinicians with an overview of current methods for prenatal genetic screening and diagnosis. Topics include developments in prenatal screening procedures such as ethnicity-based carrier testing, maternal serum screening, and ultrasonography. Diagnostic alternatives to amniocentesis include chorionic villus sampling and preimplantation diagnosis. Future endeavors such as three-dimensional ultrasonography and fetal cell sorting are discussed.
Collapse
Affiliation(s)
- Jennifer A Bubb
- Center for Human Genetics, University Hospitals of Cleveland, 11100 Euclid Avenue, LKS 1500, Cleveland, OH 44106, USA.
| | | |
Collapse
|
12
|
Niemimaa M, Heinonen S, Seppala M, Ryynanen M. The influence of smoking on the pregnancy-associated plasma protein A, free beta human chorionic gonadotrophin and nuchal translucency. BJOG 2003. [DOI: 10.1046/j.1471-0528.2003.02364.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
13
|
Rudnicka AR, Wald NJ, Huttly W, Hackshaw AK. Influence of maternal smoking on the birth prevalence of Down syndrome and on second trimester screening performance. Prenat Diagn 2002; 22:893-7. [PMID: 12378572 DOI: 10.1002/pd.440] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To determine the influence of maternal smoking on the birth prevalence of Down syndrome and on second trimester screening performance. METHODS First, a meta-analysis of cohort and case-control studies was performed to estimate the effect of maternal smoking on the live birth prevalence of Down syndrome. Then, data from 8779 women screened using the quadruple test (alphafetoprotein (AFP), unconjugated estriol (uE(3)), human chorionic gonadotrophin (free beta-hCG), and inhibin-A levels with maternal age) were used to determine the effect of smoking on the serum markers. A Monte Carlo simulation was used to assess the impact of adjusting for smoking status on screening performance. RESULTS The relative risk of Down syndrome in smokers (versus non-smokers) was 0.95 (95% confidence interval (CI) 0.87 to 1.03). Serum marker levels were determined as multiples of the median for non-smokers of the same gestational age and adjusted for maternal weight (MoM). The MoM values for AFP were 5% higher (95% CI 2-7%), uE(3) 4% lower (95% CI 2-5%), free beta-hCG 20% lower (95% CI 17-23%) and inhibin-A 62% higher (95% CI 57-67%) in smokers compared with non-smokers. Adjusting marker levels for smoking resulted in less than a 1 percentage point increase in the detection rate for a 5% false positive rate with the double, triple or quadruple tests. CONCLUSIONS There is no evidence of an association between the birth prevalence of Down syndrome and maternal smoking. The case for adjusting screening marker levels for smoking is not compelling. But if smoking data are collected routinely adjustment could be made and this would yield similar detection and false positive rates in smokers and non-smokers.
Collapse
Affiliation(s)
- Alicja R Rudnicka
- Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK.
| | | | | | | |
Collapse
|
14
|
Benn PA. Advances in prenatal screening for Down syndrome: I. general principles and second trimester testing. Clin Chim Acta 2002; 323:1-16. [PMID: 12135803 DOI: 10.1016/s0009-8981(02)00186-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Down syndrome is one of the most important causes of mental retardation in the population. In the absence of prenatal screening and diagnosis, prevalence at birth in the United States would currently exceed 1:600. The purpose of prenatal screening is to identify those women at the increased risk for an affected pregnancy and to maximize the options available to these women. TESTS AVAILABLE Second trimester serum screening involves combining the maternal age-specific risk for an affected pregnancy with the risks associated with the concentrations of maternal serum alpha-fetoprotein (MSAFP), unconjugated estriol (uE3), and human chorionic gonadotropin (hCG) (triple testing). A forth analyte, inhibin-A (INH-A), is increasingly being utilized (quadruple testing). Optimal second trimester screening requires the integration of a number of clinical variables, the most important of which is an accurate assessment of gestational age. In addition to Down syndrome, the triple and quadruple tests preferentially identify fetal trisomy 18, Turner syndrome, triploidy, trisomy 16 mosaicism, fetal death, Smith-Lemli-Opitz syndrome, and steroid sulfatase deficiency. Some programs modify the Down syndrome risks generated through maternal serum screening tests with fetal biometric data obtained by ultrasound. Other second trimester tests have shown promise, including the analysis of maternal urine and fetal cells in the maternal circulation, but none are in routine clinical use. CONCLUSION The second trimester triple and quadruple tests provide benchmarks for evaluating new screening protocols. The combination of fetal biometry, new test development as well as clarification of the role of co-factors that affect the concentrations of analytes in existing tests should lead to greater efficacy in second trimester screening for Down syndrome.
Collapse
Affiliation(s)
- Peter A Benn
- Division of Human Genetics, Department of Pediatrics, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-6140, USA.
| |
Collapse
|
15
|
Crossley JA, Aitken DA, Waugh SML, Kelly T, Connor JM. Maternal smoking: age distribution, levels of alpha-fetoprotein and human chorionic gonadotrophin, and effect on detection of Down syndrome pregnancies in second-trimester screening. Prenat Diagn 2002; 22:247-55. [PMID: 11920904 DOI: 10.1002/pd.313] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To study the levels of maternal serum alpha-fetoprotein (AFP) and human chorionic gonadotrophin (hCG) in the second trimester in smokers and non-smokers with unaffected and Down syndrome pregnancies; to examine the rate of smoking in different maternal age groups in a population having routine prenatal screening; and to assess the effect of smoking on the detection rates for Down syndrome and corresponding false-positive rates, both overall and in different maternal age groups. METHODS Information on maternal smoking status, maternal age and serum marker levels was collected from case note searches and the screening programme database on 2272 unaffected singleton pregnancies, 36 unaffected twin pregnancies and 103 singleton Down syndrome pregnancies. RESULTS In unaffected pregnancies the smokers had a median age 3.3 years less than the non-smokers, while in the Down syndrome cases the corresponding age difference was 2.0 years. Median analyte levels in multiples of the median (MoM) in the unaffected singleton pregnancies were, for non-smokers: AFP=0.97, hCG=1.04; and for smokers, AFP=1.04, hCG=0.80. In the Down syndrome pregnancies the medians were, for non-smokers: AFP=0.69, hCG=2.49; and for smokers, AFP=0.70, hCG=1.53. Correction for smoking status gave median MoMs of 1.0 for both AFP and hCG in the unaffected pregnancies in both smokers and non-smokers. In the Down syndrome cases the corrected medians were, for non-smokers: AFP=0.67, hCG=2.29; and for smokers, AFP=0.73, hCG=1.99. Before correction for maternal smoking the overall detection rate for Down syndrome was 66.7% with a false-positive rate of 6.2%. After correction the detection rate was 67.7% with a false-positive rate of 4.9%. Between the smoking and non-smoking groups there was a significant difference in the detection rate (37.5% versus 76.0%) and the false-positive rate (1.8% versus 8.1%), which disappeared after correction for smoking status (detection rate 62.5% versus 69.3%, false-positive rate 3.9% versus 5.4%). No evidence of a lower incidence of Down syndrome in smokers was found. CONCLUSIONS While correcting AFP and hCG results for maternal smoking status will have little impact on the overall detection rate for Down syndrome, it may reduce the false-positive rate and will improve the accuracy of the risks given to individual women.
Collapse
Affiliation(s)
- J A Crossley
- Institute of Medical Genetics, Yorkhill NHS Trust, Glasgow, G3 8SJ, UK.
| | | | | | | | | |
Collapse
|
16
|
Tislarić D, Brajenović-Milić B, Ristić S, Latin V, Zuvić-Butorac M, Bacić J, Petek M, Kapović M. The influence of smoking and parity on serum markers for Down's syndrome screening. Fetal Diagn Ther 2002; 17:17-21. [PMID: 11803210 DOI: 10.1159/000047999] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the impact of smoking and number of previous births on maternal serum levels of alpha-fetoprotein and free beta-subunit of human chorionic gonadotropin (free beta-hCG). METHODS The study included 3,252 completed unaffected singleton pregnancies that proceeded beyond 37 weeks' gestation and resulted with a birth of healthy child. Smoking status of mothers and data concerning gravidity and parity were collected at the sampling date. Serum markers were measured between 13 and 22 gestational weeks, corrected for maternal weight, and converted to multiples of median (MoM) for unaffected pregnancy of the corresponding gestational age. Median MoM values for both markers were examined in relation to both: smoking habits and number of previous births. RESULTS Smokers had significantly decreased free beta-hCG MoM values compared to nonsmokers (p < 0.001). The median levels showed a negative relationship with the number of previous births. The significance of a decreasing trend was proved, both in smokers (p < 0.001) and nonsmokers (p < 0.001). The median maternal serum alpha-fetoprotein MoM values did not show any significant dependence, neither with regard to smoking (p = 0.65) nor with regard to parity (p = 0.07). CONCLUSIONS The recommendable adjustment of serum markers to smoking habits, especially concerning the free beta-hCG levels, would be worthwhile. The evidence of the coexisting influence of parity on serum levels of free beta-hCG, both in smokers and nonsmokers, should perhaps be a stimulus for reconsideration of which corrections the screening performance is dependent on.
Collapse
Affiliation(s)
- Dubravka Tislarić
- Department of Endocrinology, University Hospital 'Sestre milosrdnice', Zagreb, Croatia.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Hang Lam Y, Hoi Yin Tang M. The effect of fetal gender on second-trimester maternal serum inhibin-A concentration. Prenat Diagn 2001. [DOI: 10.1002/pd.120] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
18
|
|
19
|
Affiliation(s)
- N P Groome
- School of Biological and Molecular Sciences, Oxford Brookes University, Headington, UK.
| | | |
Collapse
|
20
|
Spencer K, Ong CYT, Liao AWJ, Papademetriou D, Nicolaides KH. First trimester markers of trisomy 21 and the influence of maternal cigarette smoking status. Prenat Diagn 2000. [DOI: 10.1002/1097-0223(200010)20:10<852::aid-pd941>3.0.co;2-m] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
21
|
Abstract
In an analysis of 3111 singleton pregnancies routinely screened in the first trimester with nuchal translucency, free beta hCG and pregnancy associated plasma protein A (PAPP-A) smoking has been found to occur in 20.8 per cent of pregnant women. When the individual marker levels were assessed in smokers and non-smokers, levels of PAPP-A were reduced in smokers by some 15 per cent. Despite free beta hCG levels being reduced by 10-14 per cent in the second trimester of smoking women, in the first trimester period this is not evident. Simulation studies would suggest that in smokers the detection of trisomy 21 using free beta hCG, PAPP-A and maternal age will be reduced by some 5 to 6 per cent compared with that of the general population.
Collapse
Affiliation(s)
- K Spencer
- Endocrine Unit, Clinical Biochemistry Department, Harold Wood Hospital, Gubbins Lane, Romford, Essex, RM3 0BE, U.K
| |
Collapse
|