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© 2002 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 21:719-722 • 0278-4297

Maternal Ethnicity and Variation of Fetal Femur Length Calculations When Screening for Down Syndrome

Christine M. Kovac, MD, Jennifer A. Brown, MD, Christina C. Apodaca, MD, Peter G. Napolitano, MD, Brian Pierce, MD, Troy Patience, BS, Roderick F. Hume, Jr, MD and Byron C. Calhoun, MD

Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington.

Address correspondence and reprint requests to Christine M. Kovac, MD, Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA 98431.

Objective. To determine whether current methods for detecting Down syndrome based on fetal femur length calculations are influenced by ethnicity. Methods. The study population consisted of all fetuses scanned between 14 and 20 completed weeks' gestation from April 1, 1997, to January 1, 2000. The expected femur length was calculated from the biparietal diameter. The variance from the expected femur length, compared with the biparietal diameter, was calculated, and the mean variations were compared by maternal race. Ethnic-specific formulas for expected femur length were derived by simple regression. Results. There was a statistically significant difference in femur length in the Asian group compared with all other groups, as well as the white group compared with the black and Asian groups (P < .05). However, there was no significant difference between the black and Hispanic groups or the white and Hispanic groups. The Asian group had the largest variation, with the measured femur length being less than the expected femur length. All groups studied had a mean expected femur length less than the mean measured femur length. On the basis of the ethnic-specific formulas for femur length, there was a significant decrease in patients that would undergo further evaluation for Down syndrome. Conclusions. There is a significant difference in the mean expected femur length by biparietal diameter among fetuses in the second trimester with regard to ethnicity. Using ethnic-specific formulas for expected femur length can have a considerable impact on the use of sonographic risk factors for Down syndrome screening. Further data are required for use of femur length as a screening tool in the genetic sonogram.

Key Words: Down syndrome • ethnicity • femur length • sonographic screening

Abbreviations: BPD, biparietal diameter • FL, femur length




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C. M. Zelop, A. F. Borgida, and J. F. X. Egan
Variation of Fetal Humeral Length in Second-Trimester Fetuses According to Race and Ethnicity
J. Ultrasound Med., July 1, 2003; 22(7): 691 - 693.
[Abstract] [Full Text] [PDF]


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Copyright © 2002 by the American Institute of Ultrasound in Medicine.