{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T16:13:57Z","timestamp":1786637637559,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Despite the variety of screening tests, the number of babies born with Down's syndrome (DS) has not significantly decreased. The aim of this study was systematically review previously published meta\u2010analysis studies to identify the most efficient screening tests for DS during only the first trimester (FT) and only in the second trimester (ST) of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The data sources, including Scopus, Cochrane Library, and PubMed, were reviewed. The effectiveness of tests was investigated and compared by extracting their sensitivity and specificity values from meta\u2010analyses. The heterogeneity of data was investigated by\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      and\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      tests. In addition, publication bias was assessed through Egger's and Begg's tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study investigated 14 eligible and high\u2010quality meta\u2010analyses. Meta\u2010analysis of 13 studies revealed FT and ST as the best stage for conducting serum tests, with a sensitivity of 0.824 (CI: 0.790\u20130.857) and specificity of 0.956 (CI: 0.947\u20130.965). Likewise, FT and ST were found as the best stage for conducting ultrasound tests, with a sensitivity of 0.882 (CI: 0.850\u20130.914) and a specificity of 0.95 (CI: 0.944\u20130.956). In addition, ST was determined as the best stage for carrying out ultrasound (US) and serum screening (SS) tests, with a sensitivity of 0.93 and a specificity of 0.93, indicating the highest sensitivity and specificity of US\u2009+\u2009SS tests in the ST than FT and FT &amp; ST stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The first and second trimesters (FT and ST) is the best stage for carrying out ultrasound and serum screening tests. ST was found to be the best stage for conducting US\u2009+\u2009SS in DS screening tests. US\u2009+\u2009SS tests achieved the best results for DS screening during the FT and ST of pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.70910","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T07:35:50Z","timestamp":1753083350000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["First and Second\u2010Trimester Screening, for Down's Syndrome: An Umbrella Review on Meta\u2010Analyses"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7096-5276","authenticated-orcid":false,"given":"Zahra","family":"Goudarzi","sequence":"first","affiliation":[{"name":"Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojtaba","family":"Jafari","sequence":"additional","affiliation":[{"name":"Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Shirvani","sequence":"additional","affiliation":[{"name":"Gynecology Oncology Division, Department of Obstetrics and Gynecology, School of Medicine Shiraz University of Medical Science Shiraz Iran"},{"name":"Maternal\u2010Fetal Medicine Research Center, Department of Obstetrics and Gynecology, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmood","family":"Salesi","sequence":"additional","affiliation":[{"name":"Chemical Injuries Research Center, Systems Biology and Poisonings Institute Baqiyatallah University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khosro","family":"Keshavarz","sequence":"additional","affiliation":[{"name":"Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Emergency Medicine Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahya Namvar","family":"Jahromi","sequence":"additional","affiliation":[{"name":"Emergency Medicine Research Center Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Infertility Research Center and Shiraz Otolaryngology Research Center, Department of Otorhinolaryngology, School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0143-7"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3889\/oamjms.2021.6695"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15153"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep18866"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-2939"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci11091220"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000661"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.37001"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4431"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06477-5"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/09691413211031610"},{"issue":"5","key":"e_1_2_12_13_1","first-page":"587","article-title":"Establishment and Application of Median Serum Markers for Second Trimester Screening in Qingdao Region","volume":"29","author":"Yu D. 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