Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening.

Détails

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Etat: Public
Version: Final published version
ID Serval
serval:BIB_C9AED4088FCA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening.
Périodique
Bjog
Auteur(s)
Boyle B., Morris J.K., McConkey R., Garne E., Loane M., Addor M.C., Gatt M., Haeusler M., Latos-Bielenska A., Lelong N., McDonnell R., Mullaney C., O'Mahony M., Dolk H.
ISSN
1471-0528 (Electronic)
ISSN-L
1470-0328
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
121
Numéro
7
Pages
809-19; discussion 820
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
OBJECTIVE: To determine risk of Down syndrome (DS) in multiple relative to singleton pregnancies, and compare prenatal diagnosis rates and pregnancy outcome.
DESIGN: Population-based prevalence study based on EUROCAT congenital anomaly registries.
SETTING: Eight European countries.
POPULATION: 14.8 million births 1990-2009; 2.89% multiple births.
METHODS: DS cases included livebirths, fetal deaths from 20 weeks, and terminations of pregnancy for fetal anomaly (TOPFA). Zygosity is inferred from like/unlike sex for birth denominators, and from concordance for DS cases.
MAIN OUTCOME MEASURES: Relative risk (RR) of DS per fetus/baby from multiple versus singleton pregnancies and per pregnancy in monozygotic/dizygotic versus singleton pregnancies. Proportion of prenatally diagnosed and pregnancy outcome.
STATISTICAL ANALYSIS: Poisson and logistic regression stratified for maternal age, country and time.
RESULTS: Overall, the adjusted (adj) RR of DS for fetus/babies from multiple versus singleton pregnancies was 0.58 (95% CI 0.53-0.62), similar for all maternal ages except for mothers over 44, for whom it was considerably lower. In 8.7% of twin pairs affected by DS, both co-twins were diagnosed with the condition. The adjRR of DS for monozygotic versus singleton pregnancies was 0.34 (95% CI 0.25-0.44) and for dizygotic versus singleton pregnancies 1.34 (95% CI 1.23-1.46). DS fetuses from multiple births were less likely to be prenatally diagnosed than singletons (adjOR 0.62 [95% CI 0.50-0.78]) and following diagnosis less likely to be TOPFA (adjOR 0.40 [95% CI 0.27-0.59]).
CONCLUSIONS: The risk of DS per fetus/baby is lower in multiple than singleton pregnancies. These estimates can be used for genetic counselling and prenatal screening.
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/06/2014 15:02
Dernière modification de la notice
20/08/2019 15:44
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