Abstract
Expectant mothers who smoke have higher levels of maternal serum alpha-fetoprotein and lower levels of unconjugated estriol and total human chorionic gonadotrophin than non-smoking mothers. This significantly affects performance of screening for Down’s syndrome. This study includes 22,169 pregnant women: 18,876 non-smokers, 2,660 smoking ≤10 cigarettes/day, and 633 smoking >10 cigarettes/day. Mean maternal age (32.6 years), maternal weight (60.5 kg), and gestational age (114.7 days) were similar or only slightly different between the three groups. To verify the effects of smoking on screening, we studied retrospectively 130 sequential Down’s syndrome cases (47 from the screening program, 83 from the prenatal diagnosis program). The proportion of smokers in the Down’s syndrome and unaffected pregnancies was similar, whilst the false-positive rate and detection rate, based on fetal outcome, differed: false-positive rates were 5.63% in smokers and 9.42% in non-smokers, and detection rate 55.6% in smokers and 83.0% in non-smokers. Since the prevalence of Down’s syndrome pregnancies was the same at mid-trimester in smokers and non-smokers and the proportion of smokers was not related to maternal age, we propose an adjustment of the Down’s syndrome risk evaluation algorithm according to smoking habits.
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Wald NJ, Cuckle HS, Bereham J, et al. The effect of maternal weight on maternal serum alpha-fetoprotein. Br J Obstet Gynaecol 1981; 88: 1094.
Haddow JE, Kloza EM, Knight GJ, Smith DE. Relation between maternal weight and serum alpha-fetoprotein concentration during the second term. Clin Chem 1981; 27: 133.
Macri JW, Weiss RR, Elligers KW, Federgreen WR. Racial differences in maternal serum alpha-fetoprotein. Lancet 1976; I: 207.
Mooney RA, Arvan DA, Saller DN, French CA, Peterson CJ. Maternal serum chorionic gonadotrophin decreases with gravidity/parity. Am J Hum Genet 1994; 55: 283.
Reece EA, Davis N, Mahoney MJ, Baugarten A. Maternal serum alpha-fetoprotein in diabetic pregnancies: correlation with blood glucose control. Lancet 1987; II: 275.
Stene J, Stene E, Mikkelsen M. Risk of chromosome abnormality at amniocentesis following a child with a non-inherited chromosome aberration. A European collaborative study on prenatal diagnosis. Prenat Diagn 1984; 4: 81.
Cuckle HS, Wald NJ, Densem J, Royston P, Knight G, Haddow J, Palomaki G, Canick J. The effect of smoking in pregnancy on maternal serum alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin, progesterone and dehydroepiandrosterone sulphate levels. Br J Obstet Gynaecol 1990; 97: 272.
Cuckle HS, Alberman E, Wald NJ, Royston P, Knight GJ. Maternal smoking habits and Down’s syndrome. Prenat Diagn 1990; 10: 561.
Palomaki GE, Knight GJ, Haddow JE, Canick JA, Wald NJ, Kennard A. Cigarette smoking and levels of maternal serum alpha-fetoprotein, unconjugated estriol, and hCG: impact on Down syndrome screening. Obstet Gynecol 1993; 81: 675.
Bartels I, Hoppe-Sievert B, Bockel B, Herold S, Caesar J. Adjustment formulae for maternal serum alpha-fetoprotein, human chorionic gonadotrophin and unconjugated oestriol to maternal weight and smoking. Prenat Diagn 1993; 13: 123.
Mancini G, Perona M, Dall’ Amico D, Bollati C, Albano F, Mazzone R, Rosso M, Grosso E, Migone N, Fiocchi F, Carbonara A. Maternal serum markers. Estimation of the risk of Down’s syndrome: a prospective study. Int J Clin Lab Res 1994; 24: 49.
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Perona, M., Mancini, G., Dall’Amico, D. et al. Influence of smoking habits on Down’s syndrome risk evaluation at mid-trimester through biochemical screening. Int J Clin Lab Res 28, 179–182 (1998). https://doi.org/10.1007/s005990050040
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DOI: https://doi.org/10.1007/s005990050040