Goudarzi Zahra, Jafari Mojtaba, Shirvani Zahra, Salesi Mahmood, Keshavarz Khosro, Jahromi Bahya Namvar
Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran.
Gynecology Oncology Division, Department of Obstetrics and Gynecology, School of Medicine Shiraz University of Medical Science Shiraz Iran.
Health Sci Rep. 2025 Jul 21;8(7):e70910. doi: 10.1002/hsr2.70910. eCollection 2025 Jul.
Despite the variety of screening tests, the number of babies born with Down's syndrome (DS) has not significantly decreased. The aim of this study was systematically review previously published meta-analysis studies to identify the most efficient screening tests for DS during only the first trimester (FT) and only in the second trimester (ST) of pregnancy.
The data sources, including Scopus, Cochrane Library, and PubMed, were reviewed. The effectiveness of tests was investigated and compared by extracting their sensitivity and specificity values from meta-analyses. The heterogeneity of data was investigated by and tests. In addition, publication bias was assessed through Egger's and Begg's tests.
This study investigated 14 eligible and high-quality meta-analyses. Meta-analysis of 13 studies revealed FT and ST as the best stage for conducting serum tests, with a sensitivity of 0.824 (CI: 0.790-0.857) and specificity of 0.956 (CI: 0.947-0.965). Likewise, FT and ST were found as the best stage for conducting ultrasound tests, with a sensitivity of 0.882 (CI: 0.850-0.914) and a specificity of 0.95 (CI: 0.944-0.956). In addition, ST was determined as the best stage for carrying out ultrasound (US) and serum screening (SS) tests, with a sensitivity of 0.93 and a specificity of 0.93, indicating the highest sensitivity and specificity of US + SS tests in the ST than FT and FT & ST stages.
The first and second trimesters (FT and ST) is the best stage for carrying out ultrasound and serum screening tests. ST was found to be the best stage for conducting US + SS in DS screening tests. US + SS tests achieved the best results for DS screening during the FT and ST of pregnancy.
尽管有多种筛查测试，但唐氏综合征（DS）患儿的出生数量并未显著减少。本研究的目的是系统回顾先前发表的荟萃分析研究，以确定仅在妊娠早期（FT）和仅在妊娠中期（ST）对DS最有效的筛查测试。
对包括Scopus、Cochrane图书馆和PubMed在内的数据来源进行了回顾。通过从荟萃分析中提取测试的敏感性和特异性值来研究和比较测试的有效性。通过 和 检验研究数据的异质性。此外，通过Egger检验和Begg检验评估发表偏倚。
本研究调查了14项合格的高质量荟萃分析。对13项研究的荟萃分析显示，FT和ST是进行血清测试的最佳阶段，敏感性为0.824（CI：0.790 - 0.857），特异性为0.956（CI：0.947 - 0.965）。同样，FT和ST被发现是进行超声测试的最佳阶段，敏感性为0.882（CI：0.850 - 0.914），特异性为0.95（CI：0.944 - 0.956）。此外，ST被确定为进行超声（US）和血清筛查（SS）测试的最佳阶段，敏感性为0.93，特异性为0.93，表明US + SS测试在ST阶段比FT和FT & ST阶段具有最高的敏感性和特异性。
妊娠早期和中期（FT和ST）是进行超声和血清筛查测试的最佳阶段。在DS筛查测试中，ST被发现是进行US + SS的最佳阶段。在妊娠FT和ST期间，US + SS测试在DS筛查中取得了最佳结果。
