Insights into non-informative results from non-invasive prenatal screening through gestational age, maternal BMI, and age analyses

PLoS One. 2024 Mar 7;19(3):e0280858. doi: 10.1371/journal.pone.0280858. eCollection 2024.

Abstract

The discovery of cell-free fetal DNA fragments in the maternal plasma initiated a novel testing method in prenatal care, called non-invasive prenatal screening (NIPS). One of the limitations of NIPS is the necessity for a sufficient proportion of fetal fragments in the analyzed circulating DNA mixture (fetal fraction), otherwise, the sample is uninterpretable. We present the effect of gestational age, maternal body mass index (BMI), and maternal age on the fetal fraction (FF) of the sample. We retrospectively analyzed data from 5543 pregnant women with a single male fetus who underwent NIPS from which 189 samples received a repeat testing due to an insufficient FF. We showed the relationship between the failure rate of the samples after the repeated analysis, the FF, and the gestational age at the first sampling. Next, we found that different maternal BMI categories affect the FF and thus the chance of an informative redraw. A better understanding of the factors affecting the FF will reduce the number of non-informative calls from repeated analyzes. In this study, we provide helpful information to clinicians on how to approach non-informative analyses.

MeSH terms

  • Aneuploidy
  • Body Mass Index
  • Cell-Free Nucleic Acids*
  • Female
  • Fetus*
  • Gestational Age
  • Humans
  • Male
  • Maternal Age
  • Pregnancy
  • Prenatal Diagnosis / methods
  • Retrospective Studies

Substances

  • Cell-Free Nucleic Acids

Grants and funding

This work was supported by the PANGAIA project H2020-MSCA-RISE-2019 (Grant agreement ID: 872539) funded under H2020-EU.1.3.3. Programme and by the project UpScale of Comenius University Capacities and Competence in Research, Development and Innovation, ITMS: 313021BUZ3, co-financed by the European Regional Development Fund within the Operational Programme Integrated Infrastructure. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.