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Guo Z, Yang W, Zhao Q, Zhang Y, Wang X, Wang J, Wang R, Hao B, Liao S. Pregnancy outcomes of 4,200 fetuses with increased nuchal translucency in Henan, China. Front Med (Lausanne) 2025; 12:1514504. [PMID: 40241902 PMCID: PMC12000101 DOI: 10.3389/fmed.2025.1514504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Accepted: 03/18/2025] [Indexed: 04/18/2025] Open
Abstract
Background and objective Increased nuchal translucency (NT) thickness measured at 11-14 weeks of gestation in fetuses has been linked to adverse pregnancy outcomes. This study aimed to evaluate pregnancy outcomes in fetuses with NT ≥3.0 mm. Methods This retrospective analysis included 4,200 singleton pregnancies diagnosed with increased NT thickness (≥3.0 mm) through first-trimester ultrasound screening across 76 hospitals in Henan Province from 2017 to 2021. Follow-up on pregnancy outcomes was completed through telephone interviews and electronic medical records. Results Among the 4,200 pregnancies with NT ≥3.0 mm, adverse pregnancy outcomes were observed in 31.5% of the fetuses. These outcomes included elective termination of pregnancy (TOP), spontaneous abortion (SA), threatened abortion (TA), and live birth with malformations. A total of 547 fetuses underwent further examination through karyotype analysis after genetic counseling, revealing that 10.2% were aneuploid, primarily due to Trisomy 21 (7.1%). Conclusion The incidence of increased NT in our study was 0.49%, which was associated with chromosomal abnormalities and developmental disorders, leading to an increased risk of adverse pregnancy outcomes. Abnormal ultrasound soft markers, along with NT > 4 mm, may further elevate the risk of adverse pregnancy outcomes. These findings should be taken seriously in the context of further prenatal diagnosis for fetuses with increased NT.
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Affiliation(s)
- Zhenglong Guo
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics & National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetics Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenke Yang
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics & National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetics Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Qiongrui Zhao
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics & National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetics Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuwei Zhang
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics & National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetics Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Wang
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics & National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetics Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinming Wang
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics & National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetics Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruili Wang
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics & National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetics Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Ultrasound, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Bingtao Hao
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics & National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetics Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Shixiu Liao
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics & National Health Commission Key Laboratory of Birth Defects Prevention, Medical Genetics Institute of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
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Rybak-Krzyszkowska M, Madetko-Talowska A, Szewczyk K, Bik-Multanowski M, Sakowicz A, Stejskal D, Trková M, Smetanová D, Serafim S, Correia H, Nevado J, Angeles Mori M, Mansilla E, Rutkowska L, Kucińska A, Gach A, Huras H, Kołak M, Srebniak MI. Is Nuchal Translucency of 3.0-3.4 mm an Indication for cfDNA Testing or Microarray? - A Multicenter Retrospective Clinical Cohort Study. Fetal Diagn Ther 2024; 51:453-462. [PMID: 38815555 PMCID: PMC11446333 DOI: 10.1159/000539463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 04/15/2024] [Indexed: 06/01/2024]
Abstract
INTRODUCTION This study aimed to evaluate the occurrence of clinically relevant (sub)microscopic chromosomal aberrations in fetuses with the nuchal translucency (NT) range from 3.0 to 3.4 mm, which would be potentially missed by cfDNA testing. METHODS A retrospective data analysis of 271 fetuses with NT between 3.0 and 3.4 mm and increased first trimester combined test (CT) risk in five cohorts of pregnant women referred for invasive testing and chromosomal microarray was performed. RESULTS A chromosomal aberration was identified in 18.8% fetuses (1:5; 51/271). In 15% (41/271) of cases, trisomy 21, 18, or 13 were found. In 0.7% (2/271) of cases, sex chromosome aneuploidy was found. In 1.1% (3/271) of cases, CNV >10 Mb was detected, which would potentially also be detected by genome-wide cfDNA testing. The residual risk for missing a submicroscopic chromosome aberration in the presented cohorts is 1.8% (1:54; 5/271). CONCLUSION Our results indicate that a significant number of fetuses with increased CT risk and presenting NT of 3.0-3.4 mm carry a clinically relevant chromosomal abnormality other than common trisomy. Invasive testing should be offered, and counseling on NIPT should include the test limitations that may result in NIPT false-negative results in a substantial percentage of fetuses.
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Affiliation(s)
- Magda Rybak-Krzyszkowska
- Department of Obstetrics and Perinatology University Hospital, Krakow, Poland
- Hi-Gen Centrum Medyczne, Krakow, Poland
| | - Anna Madetko-Talowska
- Department of Medical Genetics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Szewczyk
- Department of Medical Genetics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Mirosław Bik-Multanowski
- Department of Medical Genetics, Institute of Paediatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Lodz, Poland
| | - David Stejskal
- Centre of Medical Genetics and Reproductive Medicine GENNET, Prague, Czech Republic
| | - Marie Trková
- Centre of Medical Genetics and Reproductive Medicine GENNET, Prague, Czech Republic
| | - Dagmar Smetanová
- Centre of Medical Genetics and Reproductive Medicine GENNET, Prague, Czech Republic
| | - Sílvia Serafim
- Unidade de Citogenética, Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Hildeberto Correia
- Unidade de Citogenética, Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Julian Nevado
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz- IdiPaz and Centro de Investigación Básica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- ITHACA, International Research Network in Rare Diseases, Hospital Universitario La Paz, Madrid, Spain
| | - Maria Angeles Mori
- ITHACA, International Research Network in Rare Diseases, Hospital Universitario La Paz, Madrid, Spain
| | - Elena Mansilla
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz- IdiPaz and Centro de Investigación Básica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- ITHACA, International Research Network in Rare Diseases, Hospital Universitario La Paz, Madrid, Spain
| | - Lena Rutkowska
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Agata Kucińska
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Agnieszka Gach
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Hubert Huras
- Department of Obstetrics and Perinatology University Hospital, Krakow, Poland
| | - Magdalena Kołak
- Department of Obstetrics and Perinatology University Hospital, Krakow, Poland
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Boutot M, Yardin C, Martin R, Bourthoumieu S, Aubard V, Martin S, Aubard Y, Coste-Mazeau P. Follow-up of increased nuchal translucency: Results of a study of 398 cases. J Gynecol Obstet Hum Reprod 2022; 51:102482. [DOI: 10.1016/j.jogoh.2022.102482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/06/2022] [Accepted: 10/05/2022] [Indexed: 11/08/2022]
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Su L, Wu X, Lin N, Xie X, Cai M, Wang M, Zheng L, Xu L. Different Cutoff Values for Increased Nuchal Translucency in First-Trimester Screening to Predict Fetal Chromosomal Abnormalities. Int J Gen Med 2021; 14:8437-8443. [PMID: 34819751 PMCID: PMC8608408 DOI: 10.2147/ijgm.s330960] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/03/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Increased nuchal translucency (NT) is closely related to an increased risk of chromosomal abnormalities. However, the criterion of increased NT for invasive prenatal diagnosis remains controversial, as the cutoff values are inconsistent among countries. This study was conducted to compare the various cutoff values of increased NT and calculate the incidence of chromosomal abnormalities to determine the predictive ability of these cutoff values in conventional chromosome analysis. METHODS A total of 3223 invasive samples with increased nuchal translucency (NT) or other non-ultrasound indications were collected from singleton pregnant women. Samples with isolated increased NT were divided into five groups based on the NT thickness: 909 samples in the NT ≥2.5 mm group, 819 samples in the NT ≥95th group, 547 samples in the NT ≥99th group, 527 samples in the NT ≥3.0 mm group, and 253 samples in the NT ≥3.5 mm group; 2301 samples with normal NT were considered as the control group. All five groups were karyotyped and the results were compared. The accuracy of the NT cutoff value for the screening of chromosomal abnormalities was assessed using receiver operating characteristic curve analysis. RESULTS Detection of all chromosomal aberrations and trisomy 21 showed that the sensitivity and false-positive rate decreased sequentially in the NT ≥2.5 mm, NT ≥95th, NT ≥3 mm, NT ≥99th, and NT ≥3.5 mm groups, whereas the specificity, positive predictive value, and false-negative rates increased sequentially. Comprehensive analysis of various factors, including sensitivity and specificity, revealed values equal to or higher than the calculated 95th percentile of NT distribution, which showed a sensitivity of 49.2% and specificity of 75.67% for detecting all aneuploidies and a sensitivity of 64% and specificity of 75.45% for trisomy 21, exhibiting the highest ability for the screening of chromosomal defects in first-trimester screening. CONCLUSION For different thresholds of NT thickness, values equal to or higher than the calculated 95th percentile of the NT distribution showed the highest ability for the screening of chromosomal defects in first-trimester screening.
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Affiliation(s)
- Linjuan Su
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Xiaoqing Wu
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Na Lin
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Xiaorui Xie
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Meiying Cai
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Meiying Wang
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Lin Zheng
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Liangpu Xu
- Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Medical Genetic Diagnosis and Therapy Center, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
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Buffin R, Fichez A, Decullier E, Roux A, Bin S, Combourieu D, Pastor‐Diez B, Huissoud C, Picaud J, collaborating authors BassonElianeRagouilliauxCorinneArtur DuplessisFlorenceLecomteBénédicteSuarezCorinneAndriniPierreDebillonThierryBilliemazKarenLaurichesseHélèneGallotDenisAndriniEdithVarletMarie‐NoelleGaucherandPascalMassardierJérômeChampionFabienneCharles RudigozRené. Neurodevelopmental outcome at 2 years of corrected age in fetuses with increased nuchal translucency thickness and normal karyotype compared with matched controls. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 57:790-797. [PMID: 32149439 PMCID: PMC8251540 DOI: 10.1002/uog.22009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/24/2020] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Increased nuchal translucency (NT) thickness is an antenatal marker of aneuploidy or malformation that can lead to termination of pregnancy. This study assessed the long-term neurodevelopmental prognosis of infants who had isolated increased NT in utero. METHODS This was a prospective cohort study of infants with a NT thickness > 95th percentile in the first trimester, but with a normal karyotype and no major anomalies, and controls with normal NT matched for birth weight, Apgar score, place of birth, parity and gestational age at birth. At 2 years of corrected age, all infants underwent the psychometric Brunet-Lézine test to evaluate their developmental quotient (DQ), overall (global) and specifically for the areas of posture, language, coordination and sociability. RESULTS A total of 203 chromosomally normal infants were included in the increased-NT group and 208 in the control group. The mean global DQ was significantly lower in the increased-NT group than in the control group (108.6 ± 9.7 vs 112.8 ± 8.3; P < 0.0001), but it was within the normal range expected for that age in both groups. Similarly, the mean DQs for coordination, sociability and language, but not for posture, were significantly lower in infants with increased NT than in controls. Only one case with increased NT had a DQ < 70 (defined as severe neurodevelopmental impairment), compared with none in the control group. The difference between the two groups remained significant for a NT threshold ≥ 99th percentile and when the data were adjusted for NT thickness, the infant's sex and the mother's educational level. In the increased-NT group, NT thickness was < 3.5 mm in over half (56%) of the infants, between 3.5 mm and 5 mm in 33% and > 5 mm in 11%, with a mean global DQ of 108.4, 110.1 and 109.7, respectively. CONCLUSIONS Infants who had isolated increased fetal NT in the first trimester had a significantly lower, but normal, DQ at a corrected age of 2 years, when compared with controls. The findings were independent of the infant's sex, fetal NT thickness and the mother's educational level. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- R. Buffin
- Hospices Civils de Lyon, Hôpital de la Croix‐RousseService de NéonatologieLyonFrance
- Hospices Civils de Lyon, Hôpital de la Croix‐RousseCentre Pluridisciplinaire de Diagnostic PrénatalLyonFrance
| | - A. Fichez
- Hospices Civils de Lyon, Hôpital de la Croix‐RousseCentre Pluridisciplinaire de Diagnostic PrénatalLyonFrance
| | - E. Decullier
- Hospices Civils de Lyon, Pole IMER, Unité de Recherche CliniqueLyonFrance
| | - A. Roux
- Hospices Civils de Lyon, Pole IMER, Unité de Recherche CliniqueLyonFrance
| | - S. Bin
- Hospices Civils de Lyon, Pole IMER, Unité de Recherche CliniqueLyonFrance
| | - D. Combourieu
- Hospices Civils de Lyon, Hôpital Mère EnfantCentre Pluridisciplinaire de Diagnostic PrénatalBronFrance
| | - B. Pastor‐Diez
- Hospices Civils de Lyon, Hôpital de la Croix‐RousseService de NéonatologieLyonFrance
| | - C. Huissoud
- Hospices Civils de Lyon, Hôpital de la Croix‐RousseCentre Pluridisciplinaire de Diagnostic PrénatalLyonFrance
| | - J.‐C. Picaud
- Hospices Civils de Lyon, Hôpital de la Croix‐RousseService de NéonatologieLyonFrance
- Hospices Civils de Lyon, Hôpital de la Croix‐RousseCentre Pluridisciplinaire de Diagnostic PrénatalLyonFrance
- Université Lyon 1Faculté de Médecine Lyon Sud Charles Mérieux, Pierre BéniteLyonFrance
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Kalem Z, Ellibeş Kaya A, Bakırarar B, Namlı Kalem M. Fetal nuchal translucency: is there an association with birthweight and neonatal wellbeing? Turk J Obstet Gynecol 2019; 16:35-40. [PMID: 31019838 PMCID: PMC6463433 DOI: 10.4274/tjod.galenos.2019.21384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 01/09/2019] [Indexed: 12/01/2022] Open
Abstract
Objective To evaluate the relationship between nuchal translucency (NT) values with birthweight and the wellbeing of the newborn. Materials and Methods This retrospective cohort study that included 508 patients made use of data on healthy full-term, singleton, live birth newborns in a university hospital between 2016 and 2018. The relationship between the NT multiple of the median (MoM) value and maternal body mass index, birthweight, sex, need for neonatal intensive care unit (NICU), and APGAR scores was evaluated. Similarly, the relationship between birthweight and NT MoM, and biochemical data in the first trimester was also evaluated. Results There was a positive correlation between NT and birthweight (p<0.001). The need for NICU admission increased (p=0.001), and APGAR 1st minute scores decreased (p=0.001) with increasing NT, and APGAR 5th minute scores remained unchanged (p=0.057). Conclusion The present study identified a positive correlation between first trimester NT and birthweight, and a negative correlation with the wellbeing of the neonate.
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Affiliation(s)
- Ziya Kalem
- Gürgan Clinic IVF and Women Health Center, Ankara, Turkey
| | - Aşkı Ellibeş Kaya
- Düzce University Faculty of Medicine, Department of Obstetrics and Gynecology, Düzce, Turkey
| | | | - Müberra Namlı Kalem
- Bahcesehir University, Department of Obstetrics and Gynecology, İstanbul, Turkey
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Hellmuth SG, Pedersen LH, Miltoft CB, Petersen OB, Kjaergaard S, Ekelund C, Tabor A. Increased nuchal translucency thickness and risk of neurodevelopmental disorders. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 49:592-598. [PMID: 27183961 DOI: 10.1002/uog.15961] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/28/2016] [Accepted: 05/06/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the association between fetal nuchal translucency (NT) thickness and neurodevelopmental disorders in euploid children. METHODS This study included 222 505 euploid children who had undergone routine first-trimester screening during fetal life. Children were divided according to prenatal NT into three groups: NT < 95th percentile (n = 217 103 (97.6%)); NT 95th -99th percentile (n = 4760 (2.1%)); and NT > 99th percentile (n = 642 (0.3%)). All children were followed-up to a mean age of 4.4 years. Information on diagnoses of intellectual disability, autism spectrum disorders (ASD), cerebral palsy, epilepsy and febrile seizures was obtained from national patient registries. RESULTS There was no excess risk of neurodevelopmental disorders among euploid children with first-trimester NT 95th -99th percentile. For children with NT > 99th percentile, there were increased risks of intellectual disability (odds ratio (OR), 6.16 (95% CI, 1.51-25.0), 0.31%) and ASD (OR, 2.48 (95% CI, 1.02-5.99), 0.78%) compared with children with NT < 95th percentile (incidence of 0.05% for intellectual disability and 0.32% for ASD), however, there was no detected increase in the risk of cerebral palsy (OR, 1.91 (95% CI, 0.61-5.95), 0.47%), epilepsy (OR, 1.51 (95% CI, 0.63-3.66), 0.78%) or febrile seizures (OR, 0.72 (95% CI, 0.44-1.16), 2.65%). CONCLUSIONS In a large unselected cohort of euploid children, there was no increased risk of neurodevelopmental disorders among those with a first-trimester NT 95th -99th percentile. Among euploid children with first-trimester NT > 99th percentile, there were increased risks of intellectual disability and ASD, but the absolute risk was reassuringly low (< 1%). Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- S G Hellmuth
- Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L H Pedersen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - C B Miltoft
- Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - O B Petersen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - S Kjaergaard
- Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - C Ekelund
- Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - A Tabor
- Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Äyräs O, Eronen M, Tikkanen M, Rahkola-Soisalo P, Paavonen J, Stefanovic V. Long-term outcome in apparently healthy children with increased nuchal translucency in the first trimester screening. Acta Obstet Gynecol Scand 2016; 95:541-6. [PMID: 26918672 DOI: 10.1111/aogs.12878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/15/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Increased nuchal translucency is known to be associated with chromosomal and structural defects and genetic syndromes. Little is known about the overall long-term outcome of euploid children after increased nuchal translucency. The aims of this study were to assess the additional structural defects diagnosed after discharge from the delivery hospital and the long-term overall outcome of euploid children after increased nuchal translucency and normal second trimester anomaly scan. MATERIAL AND METHODS All children from singleton euploid pregnancies during 2002-2007 with increased nuchal translucency in the first trimester screening, normal second trimester anomaly scan, and discharged as apparently healthy were included. Data on the structural defects and genetic disorders diagnosed until 2012 were retrieved from hospital databases and national registers. Previously published data of structural defects diagnosed after birth but before discharge and of severe neurodevelopmental impairment and genetic syndromes was added. RESULTS The cohort included 733 children. During the follow-up time (mean 6.5 years), major structural defects were observed in 10 (1.4%), genetic disorders in two (0.3%), and minor defects in 23 (3.1%) children. In addition, there were 42 previously published major structural defects and major neurodevelopmental impairment or genetic disorders. Adding these results together, major health problems were detected in 54 (7%) euploid children with increased fetal nuchal translucency and normal findings in second trimester anomaly scan. CONCLUSION Although only few additional major structural defects are diagnosed during the follow-up after increased fetal nuchal translucency, 7% of fetuses assumed to be healthy after second trimester anomaly scan have a major health impairment.
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Affiliation(s)
- Outi Äyräs
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki Finland, Helsinki, Finland
| | - Marianne Eronen
- Health Department, Social Insurance Institution of Finland, Helsinki, Finland
| | - Minna Tikkanen
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki Finland, Helsinki, Finland
| | - Päivi Rahkola-Soisalo
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki Finland, Helsinki, Finland
| | - Jorma Paavonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki Finland, Helsinki, Finland
| | - Vedran Stefanovic
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki Finland, Helsinki, Finland
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Le Lous M, Bouhanna P, Colmant C, Rozenberg P, Quibel T. The performance of an intermediate 16th-week ultrasound scan for the follow-up of euploid fetuses with increased nuchal translucency. Prenat Diagn 2015; 36:148-53. [DOI: 10.1002/pd.4756] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 11/18/2015] [Accepted: 11/27/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Maela Le Lous
- Department of Obstetrics and Gynecology; Poissy-Saint Germain Hospital, Versailles-Saint Quentin University; Versailles France
| | - Philippe Bouhanna
- Department of Obstetrics and Gynecology; Poissy-Saint Germain Hospital, Versailles-Saint Quentin University; Versailles France
| | - Claire Colmant
- Department of Obstetrics and Gynecology, AP-HP; Kremlin-Bicêtre Hospital, University of Paris-Sud; Orsay France
| | - Patrick Rozenberg
- Department of Obstetrics and Gynecology; Poissy-Saint Germain Hospital, Versailles-Saint Quentin University; Versailles France
| | - Thibaud Quibel
- Department of Obstetrics and Gynecology; Poissy-Saint Germain Hospital, Versailles-Saint Quentin University; Versailles France
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Wilson RD, Poon LC, Ghidini A. Current controversies in prenatal diagnosis 3: is there still a value in a nuchal translucency screening ultrasound in conjunction with maternal plasma non-invasive cell-free DNA testing? Prenat Diagn 2015; 36:20-4. [DOI: 10.1002/pd.4719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/26/2015] [Accepted: 10/27/2015] [Indexed: 11/09/2022]
Affiliation(s)
- R. Douglas Wilson
- Department of Obstetrics and Gynaecology, Cummings School of Medicine; University of Calgary; Calgary Alberta Canada
| | - Liona C. Poon
- Division of Women's Health; King's College London; London UK
| | - Alessandro Ghidini
- Perinatal Diagnostic Center; Inova Alexandria Hospital; Alexandria VA USA
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Äyräs O, Eronen M, Tikkanen M, Rahkola-Soisalo P, Paavonen J, Stefanovic V. The significance of gender in fetuses with increased nuchal translucency: pregnancy outcomes and long-term outcomes of children. Prenat Diagn 2015; 35:901-5. [DOI: 10.1002/pd.4632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 01/21/2023]
Affiliation(s)
- Outi Äyräs
- Department of Obstetrics and Gynecology; Helsinki University Hospital and University of Helsinki Finland; Helsinki Finland
| | - Marianne Eronen
- Health Department; The Social Insurance Institution of Finland; Helsinki Finland
| | - Minna Tikkanen
- Department of Obstetrics and Gynecology; Helsinki University Hospital and University of Helsinki Finland; Helsinki Finland
| | - Päivi Rahkola-Soisalo
- Department of Obstetrics and Gynecology; Helsinki University Hospital and University of Helsinki Finland; Helsinki Finland
| | - Jorma Paavonen
- Department of Obstetrics and Gynecology; Helsinki University Hospital and University of Helsinki Finland; Helsinki Finland
| | - Vedran Stefanovic
- Department of Obstetrics and Gynecology; Helsinki University Hospital and University of Helsinki Finland; Helsinki Finland
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