Journal Article

Cell-free fetal DNA testing and its correlation with prenatal indications

Dhanyamraju, Pavan Kumar, Bamme, Yevgeniya, Yu, Michael D., Li, Yan, Qiao, Bin, Wang, Jing-wei, Lyu, Yong-nan, Yang, Dongqin, Zhang, Yan, Tong, Yong-qing

2021

Overview

Background The prenatal test of cell-free fetal DNA (cffDNA) is also known as noninvasive prenatal testing (NIPT) with high sensitivity and specificity. This study is to evaluate the performance of NIPT and its clinical relevance with various clinical indications. Methods A retrospective analysis was conducted on 14,316 pregnant women with prenatal indications, including advanced maternal age (≥35 years), maternal serum screening abnormalities, the thickened nuchal translucency (≥2.5 mm) and other ultrasound abnormalities, twin pregnancy/IVF-ET pregnancy, etc. The whole-genome sequencing (WGS) of maternal plasma cffDNA was employed in this study. Results A total of 189 (1.32%) positive NIPT cases were identified, and 113/189 (59.79%)cases were confirmed by invasive prenatal testing. Abnormal serological screening (53.14%) was the most common indication, followed by elderly pregnancy (23.02%). The positive prediction value for T21, T18, T13, sex chromosome abnormalities, other autosomal aneuploidy abnormalities, and CNV abnormalities were 91.84, 68.75,37.50, 66.67, 14.29, and 6.45%, respectively. The positive rate and the true positive rate of nuchal translucency (NT) thickening were the highest (4.17 and 3.33%), followed by the voluntary requirement group (3.49 and 1.90%) in the various prenatal screening indications. The cffDNA concentration was linearly correlated with gestational age (≥10 weeks) and the positive NIPT group’s Z-score values. Conclusions whole-genome sequencing of cffDNA has extremely high sensitivity and specificity for T21, high sensitivity for T18, sex chromosome abnormalities, and T13. It also provides evidence for other abnormal chromosomal karyotypes (CNV and non-21/18/13 autosomal aneuploidy abnormalities). The cffDNA concentration is closely related to the gestational age and determines the specificity of NIPT. Our results highlight NIPT’s clinical significance, which is an effective prenatal screening tool for high-quality care of pregnancy. Highlights The whole-genome sequencing of cell-free fetal DNA from maternal plasma is an effective prenatal screening tool for pregnancies with various prenatal indications. The concentration of cffDNA was linear with gestational age and the Z-score values of the positive NIPT group. NIPT has a significant positive predictive value for pregnancies with prenatal indications.

• Publisher: BioMed Central,Springer Nature B.V,BMC
• Subject: Adolescent / Adult / Age groups / Amniocentesis / Aneuploidy / cffDNA / Childrens health / China - epidemiology / Chromosomal abnormalities / Chromosome Aberrations - embryology / Chromosome Disorders - diagnosis / Deoxyribonucleic acid / DNA / Female / Fetal Medicine / Fetuses / Genomes / Gestational age / Gynecology / Humans / Maternal & child health / Maternal and Child Health / Medical diagnosis / Medicine / Medicine & Public Health / Middle Aged / Noninvasive Prenatal Testing / Performance evaluation / Plasma / Predictive Value of Tests / Pregnancy / Pregnancy complications / Pregnancy, High-Risk / Prenatal diagnosis / Prenatal screening / Reproductive Medicine / Research Article / Retrospective Studies / Sensitivity and Specificity / Sex chromosomes / Software / Statistical analysis / Traditional Chinese medicine / Ultrasonic imaging / Whole Genome Sequencing / Womens health / Young Adult