engleski

The influence of smoking and parity on serum markers for Down's syndrome screening

Objective:To evaluate the impact of smoking and number of previous births on maternal serum levels of alpha-fetoprotein and free beta-subunit of human chorionic gonadotropin.Methods:The study included 3, 252 completed unaffected singleton pregnancies that proceeded beyond 37 weeks' gestation and resulted with a birth of healthy child. Smoking status of mothers and data concerning gravidity and parity were collected at the sampling date.serum markers were measured between 13 and 22 gestational weeks, corrected for maternal weight, and converted to miltiples of median (MoM) for unaffected pregnancy of the corresponding gestational age.Median MoM values for both markers were examined in relation to both:smoking habits and number of previous births.Results:Smokers had significantly decreased free beta-hCG MoM values compared to non.smokers(p<0.001).The median levels showed a negative relationship with the number of previous births. The significance of a decreasing trend was proved, both in smokers (p<0.001)and non-smokers(p<0.001). The median maternal serum alpha-fetoprotein MoM values did not show any significant dependence, neither with regard to smoking (p=0.65) nor with regard to parity (p=0.07). Conclusions:The recommendable adjustment of serum markers to smoking habits, especially concerning the free beta-hCG levels, would be worthwile. The evidence of the coexisting influence of parity on serum levels of free beta-hCG, both in smokers and nonsmokers, should perhaps be a stimulus for recinsideration of which corrections the screening performance is dependent on.

Down's syndrome screening; Alpha-fetoprotein; Free beta-hCG; Smoking; Parity

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