Measurement of activity of urea resistant neutrophil alkaline phosphatase as an antenatal screening test for Down's syndrome
OBJECTIVE--To investigate the value of measuring maternal urea resistant neutrophil alkaline phosphatase activity as an antenatal screening test for Down's syndrome. DESIGN--Case-control study of blood samples collected at nine to 27 weeks of pregnancy. SETTING--Antenatal clinics in London and...
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Published in | BMJ Vol. 301; no. 6759; pp. 1024 - 1026 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
London
British Medical Journal Publishing Group
03.11.1990
British Medical Association BMJ Publishing Group LTD |
Subjects | |
Online Access | Get full text |
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Summary: | OBJECTIVE--To investigate the value of measuring maternal urea resistant neutrophil alkaline phosphatase activity as an antenatal screening test for Down's syndrome. DESIGN--Case-control study of blood samples collected at nine to 27 weeks of pregnancy. SETTING--Antenatal clinics in London and Oxford. PATIENTS--72 Women whose fetuses had been diagnosed by amniocentesis or chorionic villus sampling as having Down's syndrome and 156 women whose fetuses did not have the syndrome. Only singleton pregnancies were studied. MAIN OUTCOME MEASURE--Activity of urea resistant neutrophil alkaline phosphatase measured cytochemically. RESULTS--The median enzyme activity in the index patients was 1.65 times the expected median for the controls at the same duration of pregnancy (p less than 0.0001; 95% confidence interval 1.56 to 1.74). A cut off value that identified the 5% of control patients with the highest activities yielded a rate of detection of Down's syndrome of 79% (95% confidence interval 70 to 89%). CONCLUSION--Activity of urea resistant neutrophil alkaline phosphatase is an effective maternal blood marker for Down's syndrome. Its use in antenatal screening could lead to a substantial improvement in the detection of this disorder. Before introducing the test into routine medical practice it will have to be automated so that it can be used on a large scale and is less subjective. |
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Bibliography: | href:bmj-301-1024.pdf ark:/67375/NVC-ZK8VMLN5-Q local:bmj;301/6759/1024 istex:ACE8065F461C3A4A796ABEF249A2DBFCEE196B57 PMID:2147397 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0959-8138 0959-8146 1468-5833 1756-1833 |
DOI: | 10.1136/bmj.301.6759.1024 |