title: Prenatal diagnostic testing among women referred for advanced maternal age in Beijing, 2001-2012.
abstract: OBJECTIVE
  To determine the proportion of women with advanced maternal age (AMA) undergoing amniocentesis and assess the recommended indication of 35 years or older in China.
  
  
  METHODS
  Data were retrospectively evaluated from 9641 patients who underwent diagnostic prenatal amniocentesis in Beijing, China, between January 2001 and December 2012. Maternal age, indication for testing, and karyotype data were collected. Patients referred for AMA were stratified in 2 ways: 35-37 years, 38-40 years, and 41 years or older; and indication of AMA alone or combined with other screening. Outcomes and safety performance were compared among the groups.
  
  
  RESULTS
  From 2001 to 2012, the annual rate of amniocentesis and the proportion of AMA-related indications increased (P < 0.01). Overall, 82 abnormalities were detected. In the AMA group, the spontaneous abortion rate was 0.5% (22/4748). The positive predictive value (PPV) of AMA alone was 0.5% for women aged 35-37 years. Only among women aged 41 years or older was the PPV of AMA alone better than that of AMA plus other indications (2.3% vs 1.5%, respectively).
  
  
  CONCLUSIONS
  The PPV of 35 years or older did not offset the risk of spontaneous abortion. AMA alone should not be used as an indication for amniocentesis especially among women aged 35-40 years.
authors.affiliation: Department of Obstetrics and Gynecology, Cytogenetic Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Jingmei
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Obstetrics and Gynecology, Cytogenetic Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Pan
authors.initials: P
authors.lastname: Hong
authors.affiliation: Department of Obstetrics and Gynecology, Cytogenetic Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Fu
authors.affiliation: Department of Obstetrics and Gynecology, Cytogenetic Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Obstetrics and Gynecology, Cytogenetic Laboratory, Peking University First Hospital, Beijing, China. Electronic address: yanghuixia@bjmu.edu.cn.
authors.forename: Huixia
authors.initials: H
authors.lastname: Yang
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects / Q000706:statistics & numerical data*; D002681:China; D005260:Female; D006801:Humans; D007621:Karyotyping / Q000706:statistics & numerical data; D008423:Maternal Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies
keywords: Advanced maternal age; Amniocentesis; Cytogenetic; Indication; Prenatal diagnosis