title: Effectiveness of ovarian age as the background risk for aneuploidy screening in an unselected pregnant population.
abstract: The aim of this study was to assess the performance of first-trimester combined screening when replacing the chronological maternal age by Anti-Müllerian hormone (AMH) and antral follicle count (AFC)-derived ovarian ages, as the background risk in trisomy risk estimation. A total of 639 pregnant women who completed first-trimester combined screening together with AMH and AFC determination were included. Trisomy risks were estimated based on three distinct 'maternal ages' as a-priori risk (chronological age, AMH- and AFC-derived ovarian age). The screening performance was assessed using three different approaches: received operator curve; detection rate and false positive rates for a fixed 1/250 threshold; and detection rates for a fixed 3% false positive rate. A non-significant trend was shown for AMH-derived age for both an increased area under the curve (0.986 versus 0.979) and an increased detection rate (from 83% to 100%) for a 1/250 risk threshold. For a 3% false-positive rate, a non-significant trend for increased detection with the use of both AMH- and AFC-derived ovarian ages was observed (from 67% to 83%). These results indicate that, although ovarian derived ages seem to potentially reflect a more precise background risk for fetal trisomies, the improvement in screening performance is only residual.
authors: BCNatal, Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic Barcelona, Catalonia, Spain.
authors: Maribel
authors: M
authors: Grande
authors: BCNatal, Department of Obstetrics and Gynecology, Hospital Sant Joan de Déu. Esplugues de Llobregat, Catalonia, Spain.
authors: Joan
authors: J
authors: Sabrià
authors: BCNatal, Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic Barcelona, Catalonia, Spain.
authors: Virginia
authors: V
authors: Borobio
authors: Department of Biochemistry and Molecular Genetics, CDB, Hospital Clínic Barcelona, Catalonia, Spain.
authors: Immaculada
authors: I
authors: Mercadé
authors: BCNatal, Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic Barcelona, Catalonia, Spain.
authors: Iosifina
authors: I
authors: Stergiotou
authors: BCNatal, Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic Barcelona, Catalonia, Spain.
authors: Narcís
authors: N
authors: Masoller
authors: BCNatal, Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic Barcelona, Catalonia, Spain. Electronic address: aborrell@clinic.cat.
authors: Antoni
authors: A
authors: Borrell
mesh_terms: D000293:Adolescent; D000328:Adult; D000782:Aneuploidy; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D006801:Humans; D008423:Maternal Age; D008875:Middle Aged; D006080:Ovarian Follicle / Q000000981:diagnostic imaging*; D065851:Ovarian Reserve; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis; D012306:Risk; D014314:Trisomy / Q000175:diagnosis* / Q000235:genetics; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone
keywords: anti-Müllerian hormone (AMH); antral follicle count (AFC); first trimester combined screening; trisomy 21