By how much does increased nuchal translucency increase the risk of adverse pregnancy outcome in chromosomally normal fetuses? A study of 16 260 fetuses derived from an unselected pregnant population.
Westin, Maria-Dorothea LU ; Saltvedt, S ; Almstrom, H ; Grunewald, C and Valentin, Lil LU
(2007)
In Ultrasound in Obstetrics & Gynecology
29(2).
p.150-158
- Abstract
- Objective: In this study we aimed to estimate the magnitude of a possible increase in risk of adverse outcome in fetuses with normal karyotype and increased nuchal translucency (NT), and to determine bow well NT measurements can distinguish between fetuses with normal and adverse outcome. Methods: We studied 16260 consecutive fetuses with normal karyotype derived from an unselected pregnant population. The following cut-offs for increased risk of adverse outcome were chosen a priori: NT >= 95(th) percentile, >= 3 mm, >= 3.5 mm, and >= 4.5 mm. The positive and negative likelihood ratios (+LR, -LR) of the risk cut-offs with regard to fetal malformation, miscarriage, perinatal death, termination of pregnancy and total adverse... (More)
- Objective: In this study we aimed to estimate the magnitude of a possible increase in risk of adverse outcome in fetuses with normal karyotype and increased nuchal translucency (NT), and to determine bow well NT measurements can distinguish between fetuses with normal and adverse outcome. Methods: We studied 16260 consecutive fetuses with normal karyotype derived from an unselected pregnant population. The following cut-offs for increased risk of adverse outcome were chosen a priori: NT >= 95(th) percentile, >= 3 mm, >= 3.5 mm, and >= 4.5 mm. The positive and negative likelihood ratios (+LR, -LR) of the risk cut-offs with regard to fetal malformation, miscarriage, perinatal death, termination of pregnancy and total adverse outcome were calculated, and receiver-operating characteristics (ROC) curves were drawn. Results: The total rate of adverse outcome was 2.7%. +LR and -LR of NT >= 3.0 mm were: for lethal or severe malformation, +LR 15.0 (95% CI 7.0-28.6), -LR 0.89 (95% CI 0.81-0.9S); for malformation of at least intermediate severity, +LR 8.1 (95% CI 4.3-14.0), -LR 0.95 (95% CI 0.92-0.97); for termination of pregnancy, +LR 41.6 (95% CI 17.1-86.6), -LR 0.67 (95% CI 0.41-0.85); for any adverse outcome, +LR 6.4 (95% CI 3.4-11), -LR 0.96 (95% CI 0.94-0.98). The odds for these adverse outcomes increased with increasing NT. NT >= 3 mm did not significantly increase the risk of miscarriage or perinatal death. Areas under ROC curves for NT were small, with 95% CI below or only slightly above 0.5. Conclusion: Our likelihood ratios can be used to calculate the individual risk of unfavorable outcome, but NT screening cannot reliably distinguish between normal and adverse outcome in fetuses with normal karyotype. Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/165080
- author
- Westin, Maria-Dorothea
LU
; Saltvedt, S
; Almstrom, H
; Grunewald, C
and Valentin, Lil
LU
- organization
- publishing date
- 2007
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- screening, pregnancy outcome, nuchal translucency, malformations, miscarriage, risk assessment, ultrasound
- in
- Ultrasound in Obstetrics & Gynecology
- volume
- 29
- issue
- 2
- pages
- 150 - 158
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- wos:000244580200007
- scopus:33847261045
- ISSN
- 1469-0705
- DOI
- 10.1002/uog.3905
- language
- English
- LU publication?
- yes
- id
- 73612c79-faf0-4985-94ba-877f422e6fa5 (old id 165080)
- alternative location
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids= 17211897&dopt=Abstract
- date added to LUP
- 2016-04-01 15:57:12
- date last changed
- 2022-01-28 08:16:58
@article{73612c79-faf0-4985-94ba-877f422e6fa5,
abstract = {{Objective: In this study we aimed to estimate the magnitude of a possible increase in risk of adverse outcome in fetuses with normal karyotype and increased nuchal translucency (NT), and to determine bow well NT measurements can distinguish between fetuses with normal and adverse outcome. Methods: We studied 16260 consecutive fetuses with normal karyotype derived from an unselected pregnant population. The following cut-offs for increased risk of adverse outcome were chosen a priori: NT >= 95(th) percentile, >= 3 mm, >= 3.5 mm, and >= 4.5 mm. The positive and negative likelihood ratios (+LR, -LR) of the risk cut-offs with regard to fetal malformation, miscarriage, perinatal death, termination of pregnancy and total adverse outcome were calculated, and receiver-operating characteristics (ROC) curves were drawn. Results: The total rate of adverse outcome was 2.7%. +LR and -LR of NT >= 3.0 mm were: for lethal or severe malformation, +LR 15.0 (95% CI 7.0-28.6), -LR 0.89 (95% CI 0.81-0.9S); for malformation of at least intermediate severity, +LR 8.1 (95% CI 4.3-14.0), -LR 0.95 (95% CI 0.92-0.97); for termination of pregnancy, +LR 41.6 (95% CI 17.1-86.6), -LR 0.67 (95% CI 0.41-0.85); for any adverse outcome, +LR 6.4 (95% CI 3.4-11), -LR 0.96 (95% CI 0.94-0.98). The odds for these adverse outcomes increased with increasing NT. NT >= 3 mm did not significantly increase the risk of miscarriage or perinatal death. Areas under ROC curves for NT were small, with 95% CI below or only slightly above 0.5. Conclusion: Our likelihood ratios can be used to calculate the individual risk of unfavorable outcome, but NT screening cannot reliably distinguish between normal and adverse outcome in fetuses with normal karyotype. Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd.}},
author = {{Westin, Maria-Dorothea and Saltvedt, S and Almstrom, H and Grunewald, C and Valentin, Lil}},
issn = {{1469-0705}},
keywords = {{screening; pregnancy outcome; nuchal translucency; malformations; miscarriage; risk assessment; ultrasound}},
language = {{eng}},
number = {{2}},
pages = {{150--158}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Ultrasound in Obstetrics & Gynecology}},
title = {{By how much does increased nuchal translucency increase the risk of adverse pregnancy outcome in chromosomally normal fetuses? A study of 16 260 fetuses derived from an unselected pregnant population.}},
url = {{https://lup.lub.lu.se/search/files/4523939/625854.pdf}},
doi = {{10.1002/uog.3905}},
volume = {{29}},
year = {{2007}},
}