Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening

Hdl Handle:
http://hdl.handle.net/10147/323618
Title:
Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening
Authors:
Boyle, B; Morris, JK; McConkey, R; Garne, E; Loane, M; Addor, MC; Gatt, M; Haeusler, M; Latos-Bielenska, A; Lelong, N; McDonnell, R; Mullaney, C; O'Mahony, M; Dolk, H
Citation:
Boyle B et al. Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening. Br J Ob Gyn 2014, 121 (7):809
Journal:
BJOG: An International Journal of Obstetrics & Gynaecology
Issue Date:
23-Jul-2014
URI:
http://hdl.handle.net/10147/323618
DOI:
10.1111/1471-0528.12574
Additional Links:
http://doi.wiley.com/10.1111/1471-0528.12574
Item Type:
Article
Language:
en
Keywords:
PREGNANCY; SCREENING; DOWNS SYNDROME
ISSN:
14700328
Sponsors:
OBJECTIVE: To determine risk of Down syndrome (DS) in multiple relative to singleton pregnancies, and compare prenatal diagnosis rates and pregnancy outcome. DESIGN: Population-based prevalence study based on EUROCAT congenital anomaly registries. SETTING: Eight European countries. POPULATION: 14.8 million births 1990-2009; 2.89% multiple births. METHODS: DS cases included livebirths, fetal deaths from 20 weeks, and terminations of pregnancy for fetal anomaly (TOPFA). Zygosity is inferred from like/unlike sex for birth denominators, and from concordance for DS cases. MAIN OUTCOME MEASURES: Relative risk (RR) of DS per fetus/baby from multiple versus singleton pregnancies and per pregnancy in monozygotic/dizygotic versus singleton pregnancies. Proportion of prenatally diagnosed and pregnancy outcome. STATISTICAL ANALYSIS: Poisson and logistic regression stratified for maternal age, country and time. RESULTS: Overall, the adjusted (adj) RR of DS for fetus/babies from multiple versus singleton pregnancies was 0.58 (95% CI 0.53-0.62), similar for all maternal ages except for mothers over 44, for whom it was considerably lower. In 8.7% of twin pairs affected by DS, both co-twins were diagnosed with the condition. The adjRR of DS for monozygotic versus singleton pregnancies was 0.34 (95% CI 0.25-0.44) and for dizygotic versus singleton pregnancies 1.34 (95% CI 1.23-1.46). DS fetuses from multiple births were less likely to be prenatally diagnosed than singletons (adjOR 0.62 [95% CI 0.50-0.78]) and following diagnosis less likely to be TOPFA (adjOR 0.40 [95% CI 0.27-0.59]). CONCLUSIONS: The risk of DS per fetus/baby is lower in multiple than singleton pregnancies. These estimates can be used for genetic counselling and prenatal screening.

Full metadata record

DC FieldValue Language
dc.contributor.authorBoyle, Ben_GB
dc.contributor.authorMorris, JKen_GB
dc.contributor.authorMcConkey, Ren_GB
dc.contributor.authorGarne, Een_GB
dc.contributor.authorLoane, Men_GB
dc.contributor.authorAddor, MCen_GB
dc.contributor.authorGatt, Men_GB
dc.contributor.authorHaeusler, Men_GB
dc.contributor.authorLatos-Bielenska, Aen_GB
dc.contributor.authorLelong, Nen_GB
dc.contributor.authorMcDonnell, Ren_GB
dc.contributor.authorMullaney, Cen_GB
dc.contributor.authorO'Mahony, Men_GB
dc.contributor.authorDolk, Hen_GB
dc.date.accessioned2014-07-23T10:35:59Z-
dc.date.available2014-07-23T10:35:59Z-
dc.date.issued2014-07-23-
dc.identifier.citationBoyle B et al. Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening. Br J Ob Gyn 2014, 121 (7):809en_GB
dc.identifier.issn14700328-
dc.identifier.doi10.1111/1471-0528.12574-
dc.identifier.urihttp://hdl.handle.net/10147/323618-
dc.description.sponsorshipOBJECTIVE: To determine risk of Down syndrome (DS) in multiple relative to singleton pregnancies, and compare prenatal diagnosis rates and pregnancy outcome. DESIGN: Population-based prevalence study based on EUROCAT congenital anomaly registries. SETTING: Eight European countries. POPULATION: 14.8 million births 1990-2009; 2.89% multiple births. METHODS: DS cases included livebirths, fetal deaths from 20 weeks, and terminations of pregnancy for fetal anomaly (TOPFA). Zygosity is inferred from like/unlike sex for birth denominators, and from concordance for DS cases. MAIN OUTCOME MEASURES: Relative risk (RR) of DS per fetus/baby from multiple versus singleton pregnancies and per pregnancy in monozygotic/dizygotic versus singleton pregnancies. Proportion of prenatally diagnosed and pregnancy outcome. STATISTICAL ANALYSIS: Poisson and logistic regression stratified for maternal age, country and time. RESULTS: Overall, the adjusted (adj) RR of DS for fetus/babies from multiple versus singleton pregnancies was 0.58 (95% CI 0.53-0.62), similar for all maternal ages except for mothers over 44, for whom it was considerably lower. In 8.7% of twin pairs affected by DS, both co-twins were diagnosed with the condition. The adjRR of DS for monozygotic versus singleton pregnancies was 0.34 (95% CI 0.25-0.44) and for dizygotic versus singleton pregnancies 1.34 (95% CI 1.23-1.46). DS fetuses from multiple births were less likely to be prenatally diagnosed than singletons (adjOR 0.62 [95% CI 0.50-0.78]) and following diagnosis less likely to be TOPFA (adjOR 0.40 [95% CI 0.27-0.59]). CONCLUSIONS: The risk of DS per fetus/baby is lower in multiple than singleton pregnancies. These estimates can be used for genetic counselling and prenatal screening.en_GB
dc.language.isoenen
dc.relation.urlhttp://doi.wiley.com/10.1111/1471-0528.12574en_GB
dc.rightsArchived with thanks to BJOG: An International Journal of Obstetrics & Gynaecologyen_GB
dc.subjectPREGNANCYen_GB
dc.subjectSCREENINGen_GB
dc.subjectDOWNS SYNDROMEen_GB
dc.titlePrevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screeningen_GB
dc.typeArticleen
dc.identifier.journalBJOG: An International Journal of Obstetrics & Gynaecologyen_GB
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