Effect of ethnicity on first trimester biomarkers for combined trisomy 21 screening: results from a multicenter study in six Asian countries

Prenat Diagn. 2015 Aug;35(8):735-40. doi: 10.1002/pd.4602. Epub 2015 May 27.

Abstract

Objective: To assess differences between first trimester trisomy 21 screening markers free beta chain of the human chorionic gonadotrophin (βhCG) and pregnancy-associated plasma protein A (PAPP-A) in pregnant women of six different Asian countries (China, Indonesia, Korea, Taiwan, Thailand, and Vietnam) and compare serum levels with those in women of European countries.

Methods: Median and multiple of median (MoM) values of free βhCG and PAPP-A were determined in more than 3000 pregnant women from the Asian countries during their first trimester of pregnancy. Differences in MoM values between a European reference group from a previous multicenter evaluation and the Asian population were evaluated. Two different types of population correction factors for T21 risk estimation were assessed.

Results: An at least 10% difference of median MoMs between European and Asian PAPP-A values was found to be statistically significant (p < 0.0001). The specificity of the screening did not show a big difference in individual countries, when using the country-specific correction factor compared with the overall Asian correction factor (<1.4%).

Conclusions: The use of a correction factor is recommended based on the differences in European and Asian MoM values. Developing country-specific medians in larger study populations can help identify clinical relevant differences and give the opportunity to explore a more accurate risk calculation.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Asia
  • Asian People*
  • Biomarkers / blood
  • Chorionic Gonadotropin, beta Subunit, Human / blood*
  • Down Syndrome / diagnosis*
  • Down Syndrome / ethnology
  • Europe
  • Female
  • Gestational Age
  • Humans
  • Maternal Serum Screening Tests*
  • Middle Aged
  • Pregnancy
  • Pregnancy Trimester, First / blood*
  • Pregnancy Trimester, First / ethnology
  • Pregnancy-Associated Plasma Protein-A / metabolism*
  • Reference Values
  • Risk Assessment
  • Sensitivity and Specificity
  • White People*
  • Young Adult

Substances

  • Biomarkers
  • Chorionic Gonadotropin, beta Subunit, Human
  • Pregnancy-Associated Plasma Protein-A