Maternal age-specific risks for trisomies at 9—14 weeks' gestation

This study provides data on the incidence of fetal trisomies 21, 18, and 13 at 9–14 weeks' gestation in women aged 35–45 years and estimates of maternal age-specific risks in women aged 20–45 years. Our data from 5814 singleton pregnancies undergoing first-trimester karyotyping for the sole indication of maternal age ⩾ 35 years were combined with those from two previous reports and the incidence of the trisomies was calculated from a total of 15 793 pregnancies. Comparison of incidences at 9–14 weeks' gestation with published data at 15–20 weeks' gestation and in livebirths demonstrated that at birth the maternal age-specific incidence of trisomy 21 is 33 per cent lower than at 15–20 weeks' gestation and 54 per cent lower than at 9–14 weeks' gestation. Furthermore, the relative frequency of trisomies 18 and 13 decreases from 30 per cent at 9–14 weeks to 22 per cent at 15–20 weeks and 14 per cent at birth.     

Fetal choroid plexus cysts and trisomy 18: Assessment of risk based on ultrasound findings and maternal age

This paper examines the association between fetal choroid plexus cysts (CPCs) and trisomy 18 and proposes a method by which risks can be derived taking into account both sonographic findings and maternal age. Data from our centre on the sonographic findings of 58 fetuses with trisomy 18 and 387 fetuses with CPCs as well as data from published series were used. It was calculated that the prevalence of CPCs in the general population is approximately 1 per cent and at mid-gestation the incidence of CPCs in fetuses with trisomy 18 is approximately 50 per cent. In the 387 fetuses with CPCs, the incidence of trisomy 18 increased with maternal age and the likelihood ratio for trisomy 18 increased with the number of additional abnormalities, from 0·03 for those with isolated CPCs to 0·4 if there was one additional abnormality and 20·5 if there were two or more additional abnormalities. It was concluded that if the cysts are apparently isolated, the risk for trisomy 18 is only marginally increased and maternal age should be the main factor in deciding whether or not to offer fetal karyotyping. If one additional abnormality is found, the maternal age-related risk is increased, so that even for a 20-year-old the risk for trisomy 18 is at least as high as the risk for trisomy 21 in a 35-year-old. In this respect, it may be considered desirable to offer such patients the option of karyotyping.     

Using social network analysis tools in ecology: Markov process transition models applied to the seasonal trophic network dynamics of the Chesapeake Bay

Ecosystem components interact in complex ways and change over time due to a variety of both internal and external influences (climate change, season cycles, human impacts). Such processes need to be modeled dynamically using appropriate statistical methods for assessing change in network structure. Here we use visualizations and statistical models of network dynamics to understand seasonal changes in the trophic network model described by Baird and Ulanowicz [Baird, D., Ulanowicz, R.E., 1989. Seasonal dynamics of the Chesapeake Bay ecosystem. Ecol. Monogr. 501 (59), 329–364] for the Chesapeake Bay (USA). Visualizations of carbon flow networks were created for each season by using a network graphic analysis tool (NETDRAW). The structural relations of the pelagic and benthic compartments (nodes) in each seasonal network were displayed in a two-dimensional space using spring-embedder analyses with nodes color-coded for habitat associations (benthic or pelagic). The most complex network was summer, when pelagic species such as sea nettles, larval fishes, and carnivorous fishes immigrate into Chesapeake Bay and consume prey largely from the plankton and to some extent the benthos. Winter was the simplest of the seasonal networks, and exhibited the highest ascendency, with fewest nodes present and with most of the flows shifting to the benthic bacteria and sediment POC compartments. This shift in system complexity corresponds with a shift from a pelagic- to benthic-dominated system over the seasonal cycle, suggesting that winter is a mostly closed system, relying on internal cycling rather than external input. Network visualization tools are useful in assessing temporal and spatial changes in food web networks, which can be explored for patterns that can be tested using statistical approaches. A simulation-based continuous-time Markov Chain model called SIENA was used to determine the dynamic structural changes in the trophic network across phases of the annual cycle in a statistical as opposed to a visual assessment. There was a significant decrease in outdegree (prey nodes with reduced link density) and an increase in the number of transitive triples (a triad in which i chooses j and h, and j also chooses h, mostly connected via the non-living detritus nodes in position i), suggesting the Chesapeake Bay is a simpler, but structurally more efficient, ecosystem in the winter than in the summer. As in the visual analysis, this shift in system complexity corresponds with a shift from a pelagic to a more benthic-dominated system from summer to winter. Both the SIENA model and the visualization in NETDRAW support the conclusions of Baird and Ulanowicz [Baird, D., Ulanowicz, R.E., 1989. Seasonal dynamics of the Chesapeake Bay ecosystem. Ecol. Monogr. 501 (59), 329–364] that there was an increase in the Chesapeake Bay ecosystem's ascendancy in the winter. We explain such reduced complexity in winter as a system response to lowered temperature and decreased solar energy input, which causes a decline in the production of new carbon, forcing nodes to go extinct; this causes a change in the structure of the system, making it simpler and more efficient than in summer. It appears that the seasonal dynamics of the trophic structure of Chesapeake Bay can be modeled effectively using the SIENA statistical model for network change.     

Intrauterine growth retardation and fetal transverse cerebellar diameter

In 103 small-for-gestational age (SGA) fetuses, the transverse cerebellar diameter (TCD), abdominal circumference (AC), head circumference (HC), and femur length (FL) were measured and their ratios calculated. In addition, umbilical venous blood samples were obtained by cordocentesis for measurements of fetal blood pH and erythroblast count. Compared with the AC, HC, and FL, the TCD was relatively mildly reduced. However, in the 28 fetuses with TCD >2 SDs (standard deviations) below the normal mean, the degrees of growth retardation, acidaemia, and erythroblastosis were more severe, and the incidence of perinatal death was higher than in the group with a normal sized TCD. Although in the group with TCD >2 SDs below the normal mean the TCD/AC ratio was increased, in the most severely growth-retarded fetuses this ratio was usually within the normal range. Thus, in intrauterine growth retardation (IUGR), cerebellar size is reduced in proportion to the severity of the disease and therefore the TCD cannot be used to obtain reliable information on the gestational age of small fetuses and the TCD/AC ratio does not provide reliable information as to whether or not fetuses are growth-retarded.