Counseling patients on screening for Down syndrome has long been a challenge. Findings from the FASTER trial provide solid evidence upon which to base recommendations for first- or second-trimester testing, or a combination of both.
But today in the United States, second-trimester quadruple screening remains the most popular way to test for Down syndrome.4 Assessment of maternal serum markers including alphafetoprotein (AFP), total hCG, unconjugated estriol (uE3), and inhibin-A is estimated to detect 67% to 81% of fetuses with Down syndrome, for a false-positive rate of 5%.5,6
How should ob/gyns and their patients decide amongst screening during the first trimester, the second trimester, or some combination of both? Until recently, little information has been available to guide this process, and the testing options have continued to evolve.
Who were the FASTER patients?
We excluded patients who had already had an NT measurement in the current pregnancy and/or had anencephaly or cystic hygroma detected on NT U/S. FASTER also included a separate study of karyotype and complete obstetric and pediatric outcome in patients who were diagnosed in the first trimester with a septated cystic hygroma. Those findings will be discussed later in this article.
What was the trial protocol?
The 102 sonographers in FASTER were uniformly trained to detect NT, following a standard U/S protocol. To demonstrate their proficiency with the screening, each of them submitted a minimum of 50 adequate images to a central reviewer.
Link between prenatal air pollution and reduced lung function in offspring reported
July 25th 2024Higher prenatal exposure to PM2.5 pollution is associated with reduced lung volume and airflow limitation in children, highlighting the critical impact of air pollution on in utero lung development.
Read More
Cut costs observed from out-of-home care in children with prenatal substance exposure
July 24th 2024A recent study reveals that while children exposed to maternal substance use face higher hospital costs up to age 20 years, out-of-home care significantly mitigates this financial burden.
Read More
Global progress in neonatal tetanus elimination from 2000 to 2022
July 18th 2024Incorporating maternal and neonatal tetanus elimination strategies into national immunization activities is crucial for sustaining elimination and reducing neonatal mortality worldwide, as highlighted by the latest CDC report.
Read More
PreTRM test shows efficacy in reducing severe neonatal morbidity and mortality
July 18th 2024The PreTRM test, a blood-based biomarker test for predicting preterm birth risk, has demonstrated significant efficacy in lowering severe neonatal morbidity and mortality, as reported by Sera Prognostics Inc.
Read More