Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands.
Prenat Diagn. 2010 Apr;30(4):372-7. doi: 10.1002/pd.2495.
To evaluate marker distribution of free beta-human chorionic gonadotrophin (fbeta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) in singleton pregnancies conceived by assisted reproduction techniques (ART).
In vitro fertilization (IVF) (n = 203) and intracytoplasmic sperm injection (ICSI) (n = 192) cases from a database of 14 645 first-trimester combined tests (overall study group) were selected and matched to 1164 controls for gestational age at sample date and maternal age.
In the IVF group and ICSI group, lnPAPP-A was lower (IVF 6.74 vs 7.08; P = 0.0001; ICSI 6.59 vs 7.07; P = 0.0001) compared with the matched controls. Lnfbeta-hCG was lower in the IVF group (3.75 vs 3.90; P = 0.005) but not significantly different in the ICSI group (3.87 vs 3.93; P = 0.27). The computed correction factors for PAPP-A and fbeta-hCG were 1.42 and 1.17 for the IVF group and 1.56 and 1.05 for the ICSI group.The false-positive rate (FPR) in the IVF and ICSI group compared with the matched controls was higher (IVF 10.3% vs 8.6% and ICSI 10.9% vs 7.5%). In the overall age-biased [maternal age significantly lower compared with all ART and control groups] study group the FPR was 6.8%.
The increase in FPR in the ART groups can be explained by decreased PAPP-A values. Therefore, an adjustment in risk analysis for Down syndrome is suggested.
评估辅助生殖技术（ART）受孕的单胎妊娠中游离β-人绒毛膜促性腺激素（fβ-hCG）和妊娠相关血浆蛋白-A（PAPP-A）的标记物分布。
从 14645 例早期联合检测的数据库中选择体外受精（IVF）（n=203）和胞浆内单精子注射（ICSI）（n=192）病例，并按样本日期的孕龄和产妇年龄与 1164 例对照进行匹配。
IVF 组和 ICSI 组的 lnPAPP-A 水平均低于匹配对照组（IVF：6.74 对 7.08；P=0.0001；ICSI：6.59 对 7.07；P=0.0001）。IVF 组的 lnfβ-hCG 水平较低（3.75 对 3.90；P=0.005），但 ICSI 组无显著差异（3.87 对 3.93；P=0.27）。IVF 组和 ICSI 组的 PAPP-A 和 fβ-hCG 校正因子分别为 1.42 和 1.17，1.56 和 1.05。与匹配对照组相比，IVF 组和 ICSI 组的假阳性率（FPR）较高（IVF：10.3%对 8.6%；ICSI：10.9%对 7.5%）。在以年龄为偏倚的（与所有 ART 和对照组相比，产妇年龄显著降低）总研究组中，FPR 为 6.8%。
ART 组 FPR 升高可归因于 PAPP-A 值降低。因此，建议对唐氏综合征的风险分析进行调整。
