{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T13:02:34Z","timestamp":1780059754300,"version":"3.54.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100010731","name":"Faculty of Medicine, Chiang Mai University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010731","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate the performance of a newly developed Thai non\u2010biochemical predictive model compared with the established Fetal Medicine Foundation (FMF) algorithm for prenatal screening of trisomy 21 in Southeast Asian pregnant women at 11\u201313\n                      <jats:sup>+6<\/jats:sup>\n                      \u2009weeks of pregnancy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A secondary analysis was conducted on data from pregnant women attending Maharaj Nakorn Chiang Mai Hospital, Thailand, between 2011 and 2023. Trisomy 21 risk estimates were calculated using maternal characteristics and ultrasound parameters\u2014crown\u2010rump length (CRL), nuchal translucency (NT), and fetal heart rate (FHR)\u2014via the FMF algorithm. The Thai model was developed using generalized linear regression incorporating maternal age, NT, and FHR. Risk classification thresholds were set at &lt;1:250 (low\u2010risk) and\n                      <jats:styled-content>&gt;<\/jats:styled-content>\n                      1:250 (high\u2010risk), and the models' diagnostic performances were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 8473 participants, 28 cases of trisomy 21 were identified (0.33%). The Thai model demonstrated comparable diagnostic accuracy to the FMF algorithm, with an area under the receiver operating characteristic curve (AUC) of 0.890 (95% confidence interval [CI] 0.819\u20130.961) versus 0.882 (95% CI 0.797\u20130.969) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.736). At a 1:250 cut\u2010off, the FMF algorithm achieved 60.7% sensitivity and a 2.4% false\u2010positive rate, whereas the Thai model performed optimally at a 1:100 cut\u2010off, yielding 67.9% sensitivity with a 3.5% false\u2010positive rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Thai non\u2010biochemical predictive model demonstrated similar performance to the FMF algorithm for trisomy 21 screening in Southeast Asian populations. The FMF algorithm remains a practical screening tool in low\u2010resource settings, facilitating early and accurate risk stratification where advanced biochemical screening is unavailable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70305","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T08:40:04Z","timestamp":1750149604000},"page":"1246-1252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prenatal screening for trisomy 21 in the first trimester: A comparison of a Thai non\u2010biochemical predictive model and the Fetal Medicine Foundation algorithm"],"prefix":"10.1002","volume":"171","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7152-1952","authenticated-orcid":false,"given":"Fuanglada","family":"Tongprasert","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chayanid","family":"Kunanukulwatana","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchaya","family":"Luewan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theera","family":"Tongsong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004084"},{"key":"e_1_2_9_3_1","first-page":"e1","article-title":"AIUM practice parameter for the performance of detailed diagnostic obstetric ultrasound examinations between 12\u2009weeks 0\u2009days and 13\u2009weeks 6\u2009days","volume":"40","author":"AIUM","year":"2021","journal-title":"J Ultrasound Med"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26106"},{"key":"e_1_2_9_5_1","article-title":"First trimester ultrasound tests alone or in combination with first trimester serum tests for Down's syndrome screening","volume":"3","author":"Alldred SK","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_6_1","unstructured":"FMF. The Fetal Medicine Foundation.Risk for trisomies at 11\u201313\u2009weeks.2024Accessed October 6 2024.https:\/\/www.fetalmedicine.org\/research\/assess\/trisomies"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11280-6"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4602"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1153"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4446-x"},{"key":"e_1_2_9_11_1","first-page":"152","article-title":"False positive rate of serum markers for down syndrome screening: does transportation have any effect?","volume":"95","author":"Sirichotiyakul S","year":"2012","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.03.090"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2002.01394.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.382"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2021.05.021"},{"key":"e_1_2_9_16_1","article-title":"Diagnostic accuracy of ultrasound screening for fetal structural abnormalities during the first and second trimester of pregnancy in low\u2010risk and unselected populations","volume":"5","author":"Buijtendijk MF","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_17_1","first-page":"e13","article-title":"AIUM\u2010ACR\u2010ACOG\u2010SMFM\u2010SRU practice parameter for the performance of standard diagnostic obstetric ultrasound examinations","volume":"37","author":"AIUM\u2010ACR\u2010ACOG\u2010SMFM\u2010SRU","year":"2018","journal-title":"J Ultrasound Med"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T15:29:54Z","timestamp":1763825394000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,13]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/ijgo.70305"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70305","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,13]]},"assertion":[{"value":"2025-02-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}