Effect of Maternal Hepatitis B Carrier Status on First-Trimester Markers of Down Syndrome

Abstract

Up to 10% of women of reproductive age in our country are carriers of hepatitis B virus. This study examined whether maternal hepatitis B carrier status has any effect on markers used in first-trimester screening for Down syndrome. Records for 2 major Taiwanese hospitals were retrospectively examined to identify women with singleton pregnancies resulting in normal live births from June 2002 through 2008. Maternal hepatitis B data were used to define 3 groups: seronegative women, inactive carrier women, and active carrier women. Women with active or inactive carrier status were significantly older than seronegative women. The results of the study show that maternal hepatitis B carrier status does not influence first-trimester levels of maternal serum free beta-human chorionic gonadotropin (free β-hCG) multiples of the median (MoM), pregnancy-associated plasma protein A (PAPP-A) MoM, and median fetal nuchal translucency and screening false-positive rate; therefore, correction in the risk calculation algorithm for maternal hepatitis B carrier status is not necessary.

Keywords

free beta-human chorionic gonadotropin pregnancy-associated plasma protein-A nuchal translucency hepatitis B.

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References

Shaw SW , Hsu JJ , Lee CN , Hsiao CH , Hsieh TT , Cheng PJ First- and second-trimester Down syndrome screening: current strategies and clinical guidelines. Taiwan J Obstet Gynecol. 2008; 47(2):157-162.

Spencer K. , Heath V. , El-Sheikhah A. , Ong CY , Nicolaides KH Ethnicity and the need for correction of biochemical and ultrasound markers of chromosomal anomalies in the first trimester: a study of Oriental, Asian and Afro-Caribbean populations. Prenat Diagn. 2005;25(5):365-369.

Spencer K. , Bindra R. , Nicolaides KH Maternal weight correction of maternal serum PAPP-A and free beta-hCG MoM when screening for trisomy 21 in the first trimester of pregnancy. Prenat Diagn. 2003;23(10):851-855.

Kagan KO , Frisova V. , Nicolaides KH , Spencer K. Dose dependency between cigarette consumption and reduced maternal serum PAPP-A levels at 11-13+6 weeks of gestation. Prenat Diagn. 2007;27(9):849-853.

Spencer K. , Kagan KO , Nicolaides KH Screening for trisomy 21 in twin pregnancies in the first trimester: an update of the impact of chorionicity on maternal serum markers. Prenat Diagn. 2008;28(1):49-52.

Tul N. , Novak-Antolic Z. Serum PAPP-A levels at 10-14 weeks of gestation are altered in women after assisted conception. Prenat Diagn. 2006;26(13):1206-1211.

Chen DS , Hsu NH , Sung JL , et al. A mass vaccination program in Taiwan against hepatitis B virus infection in infants of hepatitis B surface antigen-carrier mothers. JAMA. 1987; 257(19):2597-2603.

Cheng PJ , Liu CM , Chueh HY , Lin CM , Soong YK First-trimester nuchal translucency measurement and echocardiography at 16 to 18 weeks of gestation in prenatal detection for trisomy 18. Prenat Diagn. 2003;23(3):248-251.

Cheng PJ , Chang SD , Shaw SW , Soong YK Nuchal translucency thickness in fetuses with chromosomal translocation at 11-12 weeks of gestation. Obstet Gynecol. 2005;105(5 pt 1): 1058-1062.

10.

Cheng PJ , Shaw SW , Soong YK Association of fetal choroid plexus cysts with trisomy 18 in a population previously screened by nuchal translucency thickness measurement. J Soc Gynecol Investig. 2006;13(4):280-284.

11.

Nicolaides KH , Heath V. , Cicero S. Increased fetal nuchal translucency at 11-14 weeks. Prenat Diagn. 2002;22(4): 308-315.

12.

Gagnon A. , Wilson RD , Audibert F. , et al. Society of Obstetricians and Gynaecologists of Canada Genetics Committee. Obstetrical complications associated with abnormal maternal serum markers analytes. J Obstet Gynaecol Can. 2008 ;30(10): 918-949.

13.

Cowans NJ , Spencer K. First and second-trimester biochemical markers of chromosomal anomalies and their relationship to maternal haemoglobin levels. Prenat Diagn. 2005;25(8): 693-699.

14.

Einstein FH , Wright RL , Trentacoste S. , Gross S. , Merkatz IR , Bernstein PS The impact of protease inhibitors on maternal serum screening analyte levels in pregnant women who are HIV positive. Am J Obstet Gynecol. 2004;191(3):1004-1008.

15.

Cheng PJ , Liu CM , Chang SD , Lin YT , Soong YK Elevated second-trimester maternal serum hCG in patients undergoing haemodialysis . Prenat Diagn. 1999;19(10):955-958.

16.

Cheng PJ , Chu DC , Chueh HY , See LC , Chang HC , Weng DR Elevated maternal midtrimester serum free beta-human chorionic gonadotropin levels in vegetarian pregnancies that cause increased false-positive Down syndrome screening results. Am J Obstet Gynecol. 2004;190(2): 442-447.

17.

Lao TT , Tse KY , Chan LY , Tam KF , Ho LF HBsAg carrier status and the association between gestational diabetes with increased serum ferritin concentration in Chinese women. Diabetes Care. 2003;26(11):3011-3016.