کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6145330 | 1594907 | 2015 | 10 صفحه PDF | دانلود رایگان |
ObjectiveThe purpose of this study was to compare the performance of first-trimester nuchal translucency (NT) cutoff of â¥3.5 mm with NT percentiles that were calculated for crown-rump length to identify fetuses with critical congenital heart defects (CCHDs).Study DesignThis was a population-level study of singleton pregnancies in California with NT measurements performed between 11 and 14 weeks of gestation. Eligible cases were those that resulted in live births from 2009-2010 and had information about the presence or absence of CCHDs available in the hospital discharge records through age 1 year (n = 76,089). Logistic binomial regression methods were used to compare the rate of CCHDs by an NT percentile for crown-rump length and millimeter cutpoints.ResultsCompared with fetuses with an NT measurement of <90th percentile, fetuses with an NT of â¥99th percentile were >5 times as likely to have a CCHD (1.3% vs 0.2%; relative risk, 5.66; 95% confidence interval, 3.19-10.04) and fetuses with an NT measurement â¥3.5 mm were >12 times as likely to have a CCHD (2.8% vs 0.2%; relative risk, 12.28; 95% confidence interval, 5.11-29.51). NT â¥99th percentile had a sensitivity of 5.8% and a specificity of 98.9% for the detection of CCHDs compared with 2.6% and 99.8% for NT â¥3.5 mm.ConclusionResults show that NT measurements of â¥99th percentile and â¥3.5 mm are not equivalent and that substantial risk for CCHD extends to the less restrictive â¥99th percentile cutpoint. Data suggest that the use of this cutpoint compared with the current standard could double the number of CCHDs that are identified based on NT risk.
Journal: American Journal of Obstetrics and Gynecology - Volume 212, Issue 4, April 2015, Pages 518.e1-518.e10