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Abstract Objective: To systematically evaluate the value of screening Down's syndrome (DS) with pregnancy associated plasma protein-A (PAPP-A) combined with free beta chorionic gonadotropin (F-βhCG) and fetal nuchal translucency (NT) in the first trimester. Methods: According to the method of systematic review, articles related to serum PAPP-A and F-βHCG levels as well as NT in the first trimester were searched in databases, such as MEDLINE (PubMed), EMBase, Cochrane library, Wangfang, CNKI and CBM. Meta Disc 1.4 software was used for heterogeneity test and meta-analysis. Results: Twelve studies were included for this meta-analysis, including 783 cases of DS and 213 943 controls. Threshold effect heterogeneity and non-threshold effect heterogeneity were not found in twelve articles. The results of pooled sensitivity, specificity, AUC and positive likelihood ratio were 88% (95% CI: 0.86-0.90), 95% (95% CI: 0.95-0.95), 0.97, and 19.17 (95% CI: 16.8-21.9), respectively. Conclusion: When the false positive is 5%, the sensitivity of this screening method is 88%, suggesting that this method has high value of screening DS.
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