Abstract
BackgroundThe 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.MethodsA 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.ResultsA 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.Conclusionswhole-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 prenatal test of cell-free fetal DNA is known as noninvasive prenatal testing (NIPT) with high sensitivity and specificity
We measured the cell-free fetal DNA (cffDNA) from 5656 plasma samples and correlated the cffDNA concentration with Z scores from nearly 80 plasma samples with positive NIPT for trisomy 21, 18, 13
The correlation of the cffDNA concentration with the Z scores of positive NIPT further explores that cffDNA increased significantly with the Z scores of trisomy 21, 18, 13
Summary
The prenatal test of cell-free fetal DNA (cffDNA) is known as noninvasive prenatal testing (NIPT) with high sensitivity and specificity. The prenatal test of cell-free fetal DNA (cffDNA), known as noninvasive prenatal testing (NIPT) is an attractive alternative to serum screenings and invasive tests owing to its high sensitivity and specificity [1,2,3]. NIPT is primarily used for screening highrisk pregnancies such as trisomy 21, trisomy 18, and trisomy 13 It may have inconsistent results with ultrasound examination and/or actual fetal chromosome composition because the plasma cffDNA is mainly derived from placental trophoblast cells. The two most widely offered NIPT methodologies were single-nucleotide polymorphism (SNP), and the wholegenome sequencing (WGS) approaches Both share comparable clinical sensitivities for detecting common aneuploidies: T21, T18, T13, and monosomy X. We analyzed the possible causes for false-positive and false-negative NIPT results
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