Muller Peter R, Cocciolone Robert, Haan Eric A, Wilkinson Chris, Scott Heather, Sage Leonie, Bird Renata, Hutchinson Rhonda, Chan Annabelle
Department of Perinatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia 5006.
Am J Obstet Gynecol. 2007 Apr;196(4):315.e1-7; discussion 285-6. doi: 10.1016/j.ajog.2007.01.037.
The purpose of this study was to review trends in the us of maternal serum Down syndrome screening and invasive prenatal testing before and after the introduction of a state-based first-trimester combined Down syndrome screening program.
A retrospective population-based study was performed on first- and second-trimester Down syndrome screening, invasive prenatal testing, and prenatal detection of Down syndrome from 1995 to 2005 in South Australia with data from state-based registers. Chi-square tests were used to evaluate trends.
There was a significant decrease in the use of second-trimester Down syndrome maternal serum screening (from 75% in 1995 to 25% in 2005; P < .001) and a corresponding significant increase in first-trimester combined screening (from 0.8% in 2000 to 49% in 2005; P < .001). The proportion of all confinements that involved invasive prenatal testing fell (from 9.3% in 1995 to 7.6% in 2005; P < .001). There was a significant decrease in the number of invasive prenatal tests that were needed to detect 1 Down syndrome fetus (from 86 tests in 1995 to 40 tests in 2005; P < .001), with no significant change in the proportion of Down syndrome cases that were detected prenatally.
The introduction and increased use of first-trimester combined Down syndrome screening has been associated with more efficient use of invasive prenatal testing in South Australia and has maintained a high level of overall prenatal detection.
本研究旨在回顾在一个基于州的孕早期唐氏综合征联合筛查项目引入前后，美国孕妇血清唐氏综合征筛查和侵入性产前检测的趋势。
利用基于州登记处的数据，对1995年至2005年南澳大利亚州孕早期和孕中期唐氏综合征筛查、侵入性产前检测及唐氏综合征产前检测情况进行了一项基于人群的回顾性研究。采用卡方检验评估趋势。
孕中期唐氏综合征孕妇血清筛查的使用率显著下降（从1995年的75%降至2005年的25%；P<.001），而孕早期联合筛查相应显著增加（从2000年的0.8%增至2005年的49%；P<.001）。所有分娩中涉及侵入性产前检测的比例下降（从1995年的9.3%降至2005年的7.6%；P<.001）。检测出1例唐氏综合征胎儿所需的侵入性产前检测数量显著减少（从1995年的86次检测降至2005年的40次检测；P<.001），而产前检测出的唐氏综合征病例比例无显著变化。
孕早期联合唐氏综合征筛查的引入及使用增加，与南澳大利亚州更有效地使用侵入性产前检测相关，并维持了较高的总体产前检测水平。
