Gravholt C H, Juul S, Naeraa R W, Hansen J
Arhus Kommunehospital, Arhus Universitetshospital, medicinsk afdeling M.
Ugeskr Laeger. 1997 May 19;159(21):3160-6.
The prevalence of Turner's syndrome in Denmark 1970-1993 was studied and the validity of prenatal diagnosis was assessed. The study was conducted on prenatal and postnatal Turner's syndrome in the Danish Cytogenetic Central Register. All registered Turner's syndrome karyotypes (100 prenatal cases and 215 postnatal cases) at the Danish Cytogenetic Central Register were included. The main outcome measures were prevalence of Turner's syndrome karyotypes among prenatally tested fetuses and Turner's syndrome among liveborn infants. The results showed that among infant girls, prevalence of Turner's syndrome was 32/100,000. Among female fetuses tested by amniocentesis, prevalence of Turner's syndrome karyotypes was 176/100,000 (relative risk of syndrome, 6.74 compared with prevalence among untested pregnancies). Among female fetuses tested by chorion villus sampling, prevalence of syndrome karyotypes was 392/100,000 (relative risk, 16.8). We excluded prenatal tests referred because of results of ultrasound scanning: among fetuses tested by amniocentesis revised relative risk was 5.68, while revised relative risk among fetuses tested by chorion villus sampling was 13.3. For 29 fetuses with prenatal diagnosis of possible Turner's syndrome, pregnancy was allowed to continue and 24 of the children were live born. Thirteen of the liveborn children were karyotyped postnatally, and the diagnosis of Turner's syndrome had to be revised for eight, seven being normal girls and one boy. This gives a tentative predictive value of amniocentesis in the diagnosis of Turner's syndrome between 21% and 67%. There was no significant relation between mother's age and risk of Turner's syndrome. In conclusion, a discrepancy between prenatal and postnatal prevalence of Turner's syndrome challenges the specificity of prenatal examination in diagnosing Turner's syndrome.
对1970 - 1993年丹麦特纳综合征的患病率进行了研究,并评估了产前诊断的有效性。该研究基于丹麦细胞遗传学中央登记处的产前和产后特纳综合征病例展开。丹麦细胞遗传学中央登记处登记的所有特纳综合征核型(100例产前病例和215例产后病例)均被纳入。主要观察指标为产前检测胎儿中特纳综合征核型的患病率以及活产婴儿中特纳综合征的患病率。结果显示,在女婴中,特纳综合征的患病率为32/100,000。在接受羊膜穿刺术检测的女性胎儿中,特纳综合征核型的患病率为176/100,000(综合征相对风险为6.74,与未检测妊娠的患病率相比)。在接受绒毛取样检测的女性胎儿中,综合征核型的患病率为392/100,000(相对风险为16.8)。我们排除了因超声扫描结果而转诊的产前检测病例:在接受羊膜穿刺术检测的胎儿中,修正后的相对风险为5.68,而在接受绒毛取样检测的胎儿中,修正后的相对风险为13.3。对于29例产前诊断为可能患有特纳综合征的胎儿,允许妊娠继续,其中24例婴儿存活。13例存活婴儿在出生后进行了核型分析,其中8例特纳综合征的诊断不得不修正,7例为正常女孩,1例为男孩。这使得羊膜穿刺术在诊断特纳综合征中的初步预测价值在21%至67%之间。母亲年龄与特纳综合征风险之间无显著关联。总之,特纳综合征产前和产后患病率之间的差异对产前检查诊断特纳综合征的特异性提出了挑战。