{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T18:10:01Z","timestamp":1747678201519,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,11]],"date-time":"2023-02-11T00:00:00Z","timestamp":1676073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF16OC0018772","NNFSA170030576"],"award-info":[{"award-number":["NNF16OC0018772","NNFSA170030576"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To demonstrate the application of the atypicality index as an adjunct to first\u2010trimester risk assessment for major trisomies by the combined test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a study of 123\u2009998 Danish women with a singleton pregnancy who underwent routine first\u2010trimester screening, including risk assessment for major trisomies. An atypicality index, which is a measure of the degree to which a profile is atypical, was produced for measurements of fetal nuchal translucency thickness and maternal serum free \u03b2\u2010human chorionic gonadotropin and pregnancy\u2010associated plasma protein\u2010A. The incidence of adverse pregnancy outcome, including miscarriage, intrauterine death and termination of pregnancy, was tabulated according to the screening result and atypicality index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In pregnancies with low risk and those with high risk for major trisomies according to the combined screening test, the incidence of adverse pregnancy outcome increased with increasing atypicality index. In pregnancies with a low risk for trisomies and atypicality index of \u2265\u200999%, the incidence of adverse outcome was 5.1 (95%\u2009CI, 3.4\u20137.6) times higher compared with that in low\u2010risk pregnancies with a typical measurement profile, reflected by an atypicality index of &lt;\u200980%. Similarly, in high\u2010risk pregnancies, the incidence of adverse outcome was 7.9 (95%\u2009CI, 4.4\u201314.5) times higher in those with an atypicality index of \u2265\u200999% compared to those with an atypicality index of &lt;\u200980%. Using individual profile plots, we were able to demonstrate a transparent and intuitive method for visualization of multiple variables, which can help interpret the individual combination of measurements and level of atypicality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In pregnancies undergoing first\u2010trimester combined screening and classified as being at low risk for major trisomies, profiles that are typical of pregnancies with normal outcome provide additional reassurance, whereas those with an atypical profile may warrant further investigation. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26135","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T13:09:31Z","timestamp":1670245771000},"page":"333-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Atypicality index: avoiding false reassurance in prenatal screening"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4633-4738","authenticated-orcid":false,"given":"S. E.","family":"Kristensen","sequence":"first","affiliation":[{"name":"Center for Fetal Medicine, Pregnancy and Ultrasound, Department of Obstetrics Copenhagen University Hospital  Rigshospitalet Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences, Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1331-3503","authenticated-orcid":false,"given":"K.","family":"Gadsb\u00f8ll","sequence":"additional","affiliation":[{"name":"Center for Fetal Medicine, Pregnancy and Ultrasound, Department of Obstetrics Copenhagen University Hospital  Rigshospitalet Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences, Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-0711","authenticated-orcid":false,"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-0393","authenticated-orcid":false,"given":"I.","family":"Vogel","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Aarhus University Hospital  Aarhus Denmark"},{"name":"Center for Fetal Diagnostics, Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6726-1991","authenticated-orcid":false,"given":"L. H.","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Biomedicine Aarhus University  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Wright","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8517-4082","authenticated-orcid":false,"given":"O. B.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Center for Fetal Medicine, Pregnancy and Ultrasound, Department of Obstetrics Copenhagen University Hospital  Rigshospitalet Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences, Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4800-3190","authenticated-orcid":false,"given":"D.","family":"Wright","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/76.4.421"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000456329303000609"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a2547"},{"key":"e_1_2_8_5_1","unstructured":"F\u00d8TO. 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