Chang T C, Cheng H H
Department of Maternal Fetal Medicine, Kandang Kerbau Hospital, Singapore.
Med J Malaysia. 1994 Dec;49(4):351-4.
The use of maternal age alone to identify pregnant mothers at risk of a fetus with Down's syndrome has recently been supplemented by maternal serum screening using biochemical markers such as alpha-protein, human chorionic gonadotrophin and oestriol. These tests have been reported to increase the sensitivity of antenatal detection of such fetuses from 35% to 67% with a false positive rate of 5%. However, these maternal serum markers may be affected by maternal weight, the smoking history of mothers and diabetes mellitus. Furthermore, such sensitivities are achieved only when gestational age is assessed accurately by ultrasound. Many further studies need to be carried out before the introduction of maternal serum screening into routine obstetric practice in Singapore. These include studies on the incidence of Down's syndrome in the local population, studies on the distribution of these serum markers in the second trimester of pregnancy, sensitivities and positive predictive values of such a test in the local population as well as the socio-economic implications of implementing such a screening test in the local obstetric population.
仅通过孕妇年龄来识别怀有唐氏综合征胎儿风险的孕妇，最近已通过使用生化标志物（如甲胎蛋白、人绒毛膜促性腺激素和雌三醇）进行孕妇血清筛查得到补充。据报道，这些检测可将此类胎儿产前检测的敏感性从35%提高到67%，假阳性率为5%。然而，这些孕妇血清标志物可能会受到孕妇体重、母亲吸烟史和糖尿病的影响。此外，只有通过超声准确评估孕周时，才能达到这样的敏感性。在将孕妇血清筛查引入新加坡常规产科实践之前，还需要进行许多进一步的研究。这些研究包括对当地人群中唐氏综合征发病率的研究、对这些血清标志物在妊娠中期分布情况的研究、该检测在当地人群中的敏感性和阳性预测值，以及在当地产科人群中实施这种筛查检测的社会经济影响。
