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Home pregnancy tests not highly sensitive during first week of missed menses

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – A large percentage of pregnancies may go undetected by home pregnancy tests if testing is performed "as early as the first day of the missed period," as test kits routinely recommend. The findings are published today in the October 10th issue of The Journal of the American Medical Association.

Dr. Allen J. Wilcox, of the National Institute of Environmental Health Sciences in Durham, North Carolina and colleagues examined the maximum screening sensitivity of pregnancy test kits, "taking into account the natural variability of ovulation and implantation." They prospectively studied 221 healthy women between 21 and 42 years who were trying to conceive.

The researchers used the self-reported usual cycle length to measure the "day of implantation, defined by the serial assay of first morning urine samples using an extremely sensitive immunoradiometric assay for human chorionic gonadotropin (hCG), relative to the first day of the missed period, defined as the day on which women expected their next menses to begin."

Data on 136 pregnancies conceived during the study were available. In 14 of these pregnancies (10%), the blastocyst had not yet implanted by the first day of the missed menstrual period.

The team estimates that the highest screening sensitivity for an hCG-based pregnancy test is 90% on the first day of the missed period. The highest possible screening sensitivity by 1 week after the first day of the missed period was estimated to be 97%.

"Adolescents and young women are frequent users of test kits but may be especially prone to false-positive test results because they are at high risk for delayed ovulation," Dr. Wilcox and colleagues point out. "Better information on all the limits of early testing can help balance the costs and benefits of early detection against the risks of a false-negative test result."

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