Using Down syndrome serum screening results to predict low birthweight.
OBJECTIVE
To investigate the use of prenatal maternal serum screening results for Down syndrome, for the prediction of low (<2500 g) and very low (<1500 g) birthweight.


METHODS
Record linkage of maternal serum screening results with the corresponding birth records.


METHODS
42 259 women whose pregnancies had been screened for the risk of Down syndrome.


METHODS
Three East London maternity units, between February 1989 and August 1998.


RESULTS
Estimates were made of the effectiveness of single markers only for the prediction of low birthweight, and of multiple markers together with mother's weight and smoking habit. As reported previously, high levels of the single markers alpha-fetoprotein and total human chorionic gonadotrophin, inhibin A, and low levels of unconjugated oestriol were associated with low birthweight. However, the best prediction was obtained when multiple serum markers comprising alpha-fetoprotein, unconjugated oestriol, and inhibin A were used in combination together with mother's weight and adjustment for smoking habit. For a false-positive rate of 5%, this combination predicted 23% of low birthweight and 39% of very low birthweight babies, possibly the best method of prediction to date.


CONCLUSIONS
Prediction of low birthweight derived from Down syndrome screening could be used, for little extra cost, to advise on place of delivery or to select candidates for randomised clinical trials of low birthweight prevention.
Wolfson Institute of Preventive Medicine, Bart's and the London School of Medicine and Dentistry, Charterhouse Square, London, UK. thuang@nygh.on.ca
T
T
Huang
E
E
Alberman
H C
HC
Watt
N J
NJ
Wald
D000328:Adult; D015415:Biomarkers / Q000097:blood; D004314:Down Syndrome / Q000097:blood* / Q000175:diagnosis; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood*; D008403:Mass Screening / Q000706:statistics & numerical data*; D015233:Models, Statistical; D011237:Predictive Value of Tests; D011247:Pregnancy / Q000097:blood*; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis
D015415:Biomarkers