Performance of Cell-Free DNA Screening for Fetal Common Aneuploidies and Sex Chromosomal Abnormalities: A Prospective Study from a Less Developed Autonomous Region in Mainland China

Genes (Basel). 2021 Mar 25;12(4):478. doi: 10.3390/genes12040478.

Abstract

To evaluate the performance of noninvasive prenatal screening (NIPS) in the detection of common aneuploidies in a population-based study, a total of 86,262 single pregnancies referred for NIPS were prospectively recruited. Among 86,193 pregnancies with reportable results, follow-up was successfully conducted in 1160 fetuses reported with a high-risk result by NIPS and 82,511 cases (95.7%) with a low-risk result. The screen-positive rate (SPR) of common aneuploidies and sex chromosome abnormalities (SCAs) provided by NIPS were 0.7% (586/83,671) and 0.6% (505/83,671), respectively. The positive predictive values (PPVs) for Trisomy 21, Trisomy 18, Trisomy 13 and SCAs were calculated as 89.7%, 84.0%, 52.6% and 38.0%, respectively. In addition, less rare chromosomal abnormalities, including copy number variants (CNVs), were detected, compared with those reported by NIPS with higher read-depth. Among these rare abnormalities, only 23.2% (13/56) were confirmed by prenatal diagnosis. In total, four common trisomy cases were found to be false negative, resulting in a rate of 0.48/10,000 (4/83,671). In summary, this study conducted in an underdeveloped region with limited support for the new technology development and lack of cost-effective prenatal testing demonstrates the importance of implementing routine aneuploidy screening in the public sector for providing early detection and precise prognostic information.

Keywords: cell-free DNA; common aneuploidies; follow-up information; less developed region; noninvasive prenatal screening; rare chromosomal abnormalities.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aneuploidy*
  • Cell-Free Nucleic Acids / analysis
  • Cell-Free Nucleic Acids / genetics*
  • China
  • Female
  • Fetus / metabolism
  • Fetus / pathology*
  • Humans
  • Male
  • Middle Aged
  • Noninvasive Prenatal Testing / methods*
  • Pregnancy
  • Prenatal Diagnosis / methods*
  • Prospective Studies
  • Sex Chromosome Aberrations*
  • Trisomy / diagnosis*
  • Trisomy / genetics
  • Young Adult

Substances

  • Cell-Free Nucleic Acids