Down syndrome maternal serum screening in patients with renal disease.

OBJECTIVE

The objective of the study was to determine the value of maternal serum Down syndrome screening in patients affected by renal disease.

STUDY

DESIGN

A study group of 54 pregnant women with renal diseases defined before pregnancy, was compared with a control group of 108 patients matched for maternal age, maternal weight, smoking status, and gestational age. Maternal serum markers (free beta-human chorionic gonadotropin [hCG], total hCG, alpha-fetoprotein) expressed in multiple of median and maternal renal function markers (creatinine, beta2-microglobulin, alpha1-microglobulin) were assayed.

RESULTS

The percentage of patients in the Down syndrome at-risk group (>1:250) using free beta-hCG was significantly higher (P < .02) in the renal disease group (48%) than in the control group (12%). No significant difference was observed for total hCG (25% vs 15%).

CONCLUSION

Down syndrome screening using free beta-hCG is not applicable in patients with renal disease whatever the maternal serum creatinine and can be used with caution when total hCG is used.