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Ultrasound Obstet Gynecol. 2016 Jan;47(1):38-44. doi: 10.1002/uog.15820.

Risk of fetal loss associated with invasive testing following combined first-trimester screening for Down syndrome: a national cohort of 147,987 singleton pregnancies.

Author information

1
Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
2
Faculty of Medicine and Health Sciences, University of Copenhagen, Copenhagen, Denmark.
3
Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
4
Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, Denmark.
5
Fetal Medicine Unit, Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Denmark.

Abstract

OBJECTIVE:

To assess prospectively the risk of fetal loss associated with chorionic villus sampling (CVS) and amniocentesis (AC) following combined first-trimester screening (cFTS) for Down syndrome.

METHODS:

This was a nationwide population-based study (Danish Fetal Medicine Database, 2008-2010) including 147,987 women with singleton pregnancy who underwent cFTS. Propensity score stratification was used to assess the risk of fetal loss with and without invasive testing. Analyses were performed between 3 and 21 days after cFTS for CVS and between 28 and 42 days after cFTS for AC. Results are reported as average risk differences with 95% CIs.

RESULTS:

The risks of miscarriage and stillbirth were not higher in women exposed to CVS or AC compared with unexposed women, independent of the analysis time-point. The average effect of CVS on risk of miscarriage was -0.08% (95% CI, -0.64; 0.47) at 3 days and -0.21% (95% CI, -0.58; 0.15) at 21 days after cFTS, while the effect on risk of stillbirth was -0.18% (95% CI, -0.50; 0.13) at 3 days and -0.27% (95% CI, -0.58; 0.04) at 21 days after cFTS. Regarding the effect of AC on risk of miscarriage, the analysis at 28 days after cFTS showed an average effect of 0.56% (95% CI, -0.21; 1.33), while the effect on risk of stillbirth was 0.09% (95% CI, -0.39; 0.58) at 42 days after cFTS.

CONCLUSION:

Neither CVS nor AC was associated with increased risk of miscarriage or stillbirth. These findings indicate that the procedure-related risk of CVS and AC is very low.

KEYWORDS:

amniocentesis; chorionic villus sampling; combined first-trimester screening; fetal loss; invasive prenatal testing; miscarriage; procedure-related risk; stillbirth

PMID:
26581188
DOI:
10.1002/uog.15820
[Indexed for MEDLINE]
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