Prefumo Federico, Sairam Shanthi, Bhide Amarnath, Penna Leonie, Hollis Brian, Thilaganathan Baskaran
Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London, UK.
BJOG. 2004 Feb;111(2):109-12. doi: 10.1046/j.1471-0528.2003.00025.x-i1.
Failure to visualise the fetal nasal bones at 11-14 weeks of gestation is associated with a significant increase in the risk for trisomy 21. However, it is not known whether the ethnic origin of the mother has any effect on the fetal profile and the prevalence of this marker.
Prospective study.
London Teaching Hospital.
Four thousand and four hundred and ninety-two consecutive fetuses undergoing routine first trimester ultrasound scanning at 11-14 weeks of gestation in a multiethnic population.
Examination of the nasal bones was attempted in the fetuses.
Rate of visualisation of the fetal nasal bones.
Five hundred fetuses were excluded from the analysis because of chromosomal abnormalities or a technically unsatisfactory examination. In the remaining 3992 fetuses, the maternal ethnic origin was African in 13.0%, Asian in 15.3% and Caucasian in 66.0%. Compared with Caucasians, the failure to visualise the fetal nasal bones was significantly higher in women of African (P= 0.0001) but not Asian origin (P= 0.24). A multivariable logistic regression model showed that having a mother of African origin is still significantly associated with an increased likelihood of absent fetal nasal bones compared with Caucasians (odds ratio 2.33), even after correcting for maternal age, parity and crown-rump length.
There is a significant difference in the rate of visualisation of the fetal nasal bones in the first trimester in mothers of different ethnic origin. This suggest that corrections for maternal ethnicity will be required to ensure equity of fetal nasal bone screening in multiracial populations. Whether corrections are required for the father's ethnic origin remains to be determined.
妊娠11 - 14周时无法观察到胎儿鼻骨与21三体综合征风险显著增加相关。然而，尚不清楚母亲的种族起源是否会对胎儿轮廓及该标志物的发生率产生任何影响。
前瞻性研究。
伦敦教学医院。
在一个多民族人群中，4492例连续接受妊娠11 - 14周常规孕早期超声扫描的胎儿。
尝试对胎儿的鼻骨进行检查。
胎儿鼻骨的可视化率。
由于染色体异常或检查技术不达标，500例胎儿被排除在分析之外。在其余3992例胎儿中，母亲的种族起源为非洲裔的占13.0%，亚裔的占15.3%，白种人的占66.0%。与白种人相比，非洲裔女性无法观察到胎儿鼻骨的比例显著更高（P = 0.0001），而亚裔女性则不然（P = 0.24）。多变量逻辑回归模型显示，即使校正了母亲年龄、产次和顶臀长度，与白种人相比，母亲为非洲裔的胎儿鼻骨缺失可能性仍显著增加（优势比2.33）。
不同种族起源母亲在孕早期胎儿鼻骨可视化率上存在显著差异。这表明在多种族人群中进行胎儿鼻骨筛查时，需要对母亲种族进行校正以确保公平性。父亲种族是否需要校正仍有待确定。
