Yi Zhou1, Zhongyi Zhu2, Ya Gao2, Yuying Yuan2, Yulai Guo2, Lijun Zhou2, KaiKai Liao2, Jun Wang2, Bole Du2, Yumei Hou2, Zhonglin Chen2, Fang Chen3, Hongyun Zhang2, Cong Yu2, Lijian Zhao2, T K Lau4, Fuman Jiang5, Wei Wang6. 1. Fetal Medicine Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China. 2. Clinical Laboratory of BGI Diagnostics, BGI-Shenzhen, Shenzhen, China. 3. BGI-Research, BGI-Shenzhen, Shenzhen, China Shenzhen Birth Defect Screening Project Lab, BGI-Shenzhen, Shenzhen, China. 4. Fetal Medicine Centre, Paramount Medical Centre, Hong Kong. 5. Clinical Laboratory of BGI Diagnostics, BGI-Shenzhen, Shenzhen, China jiangfuman@genomics.cn wangw@genomics.cn. 6. Clinical Laboratory of BGI Diagnostics, BGI-Shenzhen, Shenzhen, China BGI-Research, BGI-Shenzhen, Shenzhen, China Shenzhen Birth Defect Screening Project Lab, BGI-Shenzhen, Shenzhen, China jiangfuman@genomics.cn wangw@genomics.cn.
Abstract
OBJECTIVE: To study factors that influence the concentration of cell-free fetal DNA (fetal fraction) using a large clinical data set of pregnancies with male fetus. METHOD: A retrospective analysis of 23 067 pregnancies that received noninvasive prenatal testing from January 2012 to October 2013, including 22 650 normal singleton pregnancies (control group) and 417 pregnancies with aneuploidy, twin pregnancy, or various maternal conditions including preexisting hypertension, preexisting diabetes, hyperthyroidism, and carrier of the surface antigen of the hepatitis B virus (HBsAg; study group). Multiples of the median (MoM) analysis was performed in the control group to derive gestation and body mass index (BMI)-corrected fetal fraction. The effects of study group conditions on fetal fraction were examined by calculating the ratio of MoM (RMoM) values. RESULTS: Fetal fraction showed a positive correlation with gestational age (r(2) = .10, P < .001) and increased rapidly after the 21 weeks of gestation (r(2) = .26, P < .001). Negative association with maternal BMI was found with fetal fraction (r(2) = .04, P < .001). In study group, fetal fraction was higher among pregnant women with a trisomy 21 fetus (RMoM = 1.24, P < .001) and lower among trisomy 18 (RMoM = 0.84, P < .001). A 1.6-fold incensement of fetal fraction was observed in twin fetuses comparing to singleton pregnancy (RMoM = 1.62, P < .001). Women with preexisting hypertension had significantly lower fetal fraction (RMoM = 0.85, P = .02). Preexisting diabetes, hyperthyroidism, or carrier of HBsAg did not affect fetal fraction. CONCLUSION: The fetal fraction was affected by fetal aneuploidy, maternal BMI, and the number of gestation. Maternal preexisting of hypertension appeared to reduce fetal fraction.
OBJECTIVE: To study factors that influence the concentration of cell-free fetal DNA (fetal fraction) using a large clinical data set of pregnancies with male fetus. METHOD: A retrospective analysis of 23 067 pregnancies that received noninvasive prenatal testing from January 2012 to October 2013, including 22 650 normal singleton pregnancies (control group) and 417 pregnancies with aneuploidy, twin pregnancy, or various maternal conditions including preexisting hypertension, preexisting diabetes, hyperthyroidism, and carrier of the surface antigen of the hepatitis B virus (HBsAg; study group). Multiples of the median (MoM) analysis was performed in the control group to derive gestation and body mass index (BMI)-corrected fetal fraction. The effects of study group conditions on fetal fraction were examined by calculating the ratio of MoM (RMoM) values. RESULTS: Fetal fraction showed a positive correlation with gestational age (r(2) = .10, P < .001) and increased rapidly after the 21 weeks of gestation (r(2) = .26, P < .001). Negative association with maternal BMI was found with fetal fraction (r(2) = .04, P < .001). In study group, fetal fraction was higher among pregnant women with a trisomy 21 fetus (RMoM = 1.24, P < .001) and lower among trisomy 18 (RMoM = 0.84, P < .001). A 1.6-fold incensement of fetal fraction was observed in twin fetuses comparing to singleton pregnancy (RMoM = 1.62, P < .001). Women with preexisting hypertension had significantly lower fetal fraction (RMoM = 0.85, P = .02). Preexisting diabetes, hyperthyroidism, or carrier of HBsAg did not affect fetal fraction. CONCLUSION: The fetal fraction was affected by fetal aneuploidy, maternal BMI, and the number of gestation. Maternal preexisting of hypertension appeared to reduce fetal fraction.
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