Screening for Down syndrome in dichorionic twin pregnancies conceived by in vitro fertilization (IVF): a clinical pilot study to confirm the laboratory methods |
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Authors: | Lissa Francois Lindsay Kugler Jacobo L. Santolaya Revital Faro Valeria Di Stefano Lena Merjanian Joaquin Santolaya-Forgas |
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Affiliation: | 1.Departments of Obstetrics, Gynecology and Reproductive Sciences,Rutgers-Robert Wood Johnson Medical School,New Brunswick,USA;2.Jersey Shore University Medical Center,Neptune,USA;3.Center for OBGYN Research and Mentorship, Department of Obstetrics, Gynecology & Reproductive Sciences, Department of Human Genetics,Robert Wood Johnson Medical School at Rutgers the State University of New Jersey,New Brunswick,USA |
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Abstract: | PurposeThe corrections necessary to estimate the risk for Down syndrome in twin pregnancies have been pointed out. We performed a nested controlled study to evaluate the validity of these corrections in dichorionic twins conceived by IVF.MethodsDetailed clinical data was collected from the medical records. Twins were matched with a contemporaneous cohort of spontaneously conceived singleton pregnancies that serve as reference in a 1 to 4 ratio. All patients had their entire obstetrical care at our Hospital. The Student t-test was used for group comparisons and a p-value <0.05 was considered significant.ResultsNineteen sets of normal twins concordant in size and with appropriate weight for gestational age were matched with 80 normal and mature newborns. Significant differences between groups were found for maternal age, gestational age at delivery and newborn weight (all p < 0.01). No statistical differences were noted for the levels of the biochemical markers expressed as multiples of the median. However, a 15 % closer approximation to the laboratory median for PAPP-A and a 10 % closer approximation to the laboratory median for free β-hCG was evident in twins when compared to the reference group.ConclusionsThese findings support the methods used to estimate the risk for Down syndrome in dichorionic twin pregnancies conceived after IVF. A future study with a larger sample size could confirm if the laboratory corrections done on the combined screening test improve the predictability of Down syndrome in dichorionic twin pregnancy conceived by IVF when compared to singleton pregnancies. |
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Keywords: | Twin pregnancies IVF First trimester combined screening test Down syndrome screening Free β-hCG PAPP-A |
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