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Balaguer N, Rodrigo L, Mateu-Brull E, Campos-Galindo I, Castellón JA, Al-Asmar N, Rubio C, Milán M. Non-invasive cell-free DNA-based approach for the diagnosis of clinical miscarriage: A retrospective study. BJOG 2024; 131:213-221. [PMID: 37533357 DOI: 10.1111/1471-0528.17629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVE To evaluate cell-free DNA (cfDNA) testing as a non-invasive approach to detecting aneuploidies in clinical miscarriages. DESIGN A retrospective cohort study of women with pregnancy loss. SETTING Hospitals and genetic analysis laboratories. POPULATION OR SAMPLE Pregnancy losses in the period 2021-2022. METHODS Results derived from non-invasive cfDNA testing (Veriseq NIPT Solution V2) of maternal blood and invasive analysis of products of conception (POC) (Ion ReproSeq) compared in 120 women who suffered a miscarriage. MAIN OUTCOME MEASURES Concordance rate results, cfDNA testing performance, non-informative rate (NIR) and fetal fraction (FF). RESULTS We found no significant differences in the NIR between invasive (iPOC) and non-invasive (niPOC) analysis of POC (10.0% [12/120] versus 16.7% [20/120]). Of 120 samples, 90 provided an informative result in iPOC and niPOC groups (75%). cfDNA analysis correctly identified 74/87 (85.1%) samples (excluding triploidies). Sensitivity and specificity were 79.4% and 100%, respectively; all discordant cases were female. A binomial logistic model suggested fetal sex as the only variable influencing the concordance rate (P = 0.035). A Y-chromosome-based FF estimate allowed the optimal reclassification of cfDNA of non-informative male fetuses and a more accurate evaluation of cfDNA testing performance. The difference between the two FF estimates (native algorithm and Y-chromosome-based) suggests that female non-concordant cases may represent non-informative cases. CONCLUSIONS Cell-free DNA-based testing provides a non-invasive approach to determining the genetic cause of clinical miscarriage.
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Affiliation(s)
- Nuria Balaguer
- Prenatal Diagnosis Department, Igenomix Spain Lab S.L.U., Paterna, Spain
| | - Lorena Rodrigo
- Preimplantation Genetic Testing for Aneuploidies (PGT-A) Department, Igenomix Spain Lab S.L.U., Paterna, Spain
| | - Emilia Mateu-Brull
- Prenatal Diagnosis Department, Igenomix Spain Lab S.L.U., Paterna, Spain
| | - Inmaculada Campos-Galindo
- Preimplantation Genetic Testing for Aneuploidies (PGT-A) Department, Igenomix Spain Lab S.L.U., Paterna, Spain
| | | | | | - Carmen Rubio
- Research and Development Department, Igenomix Spain Lab S.L.U., Paterna, Spain
| | - Miguel Milán
- Prenatal Diagnosis Department, Igenomix Spain Lab S.L.U., Paterna, Spain
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2
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Ju J, Li J, Liu S, Zhang H, Xu J, Lin Y, Gao Y, Zhou Y, Jin X. Estimation of cell-free fetal DNA fraction from maternal plasma based on linkage disequilibrium information. NPJ Genom Med 2021; 6:85. [PMID: 34642337 PMCID: PMC8511193 DOI: 10.1038/s41525-021-00247-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 09/23/2021] [Indexed: 11/21/2022] Open
Abstract
Cell-free fetal DNA fraction (FF) in maternal plasma is a key parameter affecting the performance of noninvasive prenatal testing (NIPT). Accurate quantitation of FF plays a pivotal role in these tests. However, there are few methods that could determine FF with high accuracy using shallow-depth whole-genome sequencing data. In this study, we hypothesized that the actual FF in maternal plasma should be proportional to the discrepancy rate between the observed genotypes and inferred genotypes based on the linkage disequilibrium rule in certain polymorphism sites. Based on this hypothesis, we developed a method named Linkage Disequilibrium information-based cell-free Fetal DNA Fraction (LDFF) to accurately quantify FF in maternal plasma. This method achieves a high performance and outperforms existing methods in the fetal DNA fraction estimation. As LDFF is a gender-independent method and developed on shallow-depth samples, it can be easily incorporated into routine NIPT test and may enhance the current NIPT performance.
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Affiliation(s)
- Jia Ju
- College of Life Sciences, University of Chinese Academy of Sciences, 100049, Beijing, China
- BGI-Shenzhen, 518083, Shenzhen, Guangdong, China
| | - Jia Li
- BGI-genomics, BGI-Shenzhen, 518083, Shenzhen, Guangdong, China
| | - Siyang Liu
- BGI-Shenzhen, 518083, Shenzhen, Guangdong, China
| | | | - Jinjin Xu
- BGI-Shenzhen, 518083, Shenzhen, Guangdong, China
| | - Yu Lin
- BGI-Shenzhen, 518083, Shenzhen, Guangdong, China
| | - Ya Gao
- BGI-Shenzhen, 518083, Shenzhen, Guangdong, China
| | - Yulin Zhou
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine & School of Public Health, Xiamen University, 361102, Xiamen, Fujian, China.
| | - Xin Jin
- BGI-Shenzhen, 518083, Shenzhen, Guangdong, China.
- School of Medicine, South China University of Technology, 510006, Guangzhou, Guangdong, China.
- Guangdong Provincial Key Laboratory of Human Disease Genomics, Shenzhen Key Laboratory of Genomics, BGI-Shenzhen, 518083, Shenzhen, China.
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3
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Rafalko J, Caldwell S, Soster E, Almasri E, McLennan G, Liu T, Weinblatt V, Cacheris P, McCullough R. Application of mosaicism ratio to multifetal gestations. PLoS One 2021; 16:e0248467. [PMID: 33711042 PMCID: PMC7954340 DOI: 10.1371/journal.pone.0248467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/28/2021] [Indexed: 12/02/2022] Open
Abstract
Mosaicism ratio, or MR, is a laboratory metric that can be calculated using massively parallel sequencing data from cell-free DNA (cfDNA) screening. MR compares the amount of cfDNA present from a particular chromosome or chromosomal region to the overall fetal fraction of the specimen. In singleton gestations, MR may be used to refine the positive predictive value of an abnormal cfDNA screening result by identifying cases that could be impacted by various biological factors, such as placental mosaicism or prior co-twin demise. The current study was designed to examine the behavior of mosaicism ratio (MR) in multifetal gestations. Multifetal cfDNA specimens with positive results for trisomies 21, 18, or 13 and confirmed diagnostic outcomes were compiled to examine MR of the aneuploid chromosome based on the number of affected fetuses/placentas. A second multifetal cohort was assembled to analyze the MR of the Y chromosome in cases with at least one male fetus. For aneuploid cases, the average MR of affected singletons (used as a biological proxy for two affected twins) was significantly higher than the average MR for twins in which one fetus was affected. The average MR of the aneuploid chromosome for one affected twin was 52%, 42%, and 48% of that of singleton gestations for trisomy 21, 18, and 13 cases, respectively. MR cutoffs of 0.7 for trisomy 21, and 0.5 for trisomies 18 and 13 may help predict whether one versus both twins are affected with aneuploidy when clinical concern arises. For male cases, the Y MR of XX/XY gestations was 48% of the Y MR for XY/XY gestations. Using a Y MR cutoff of 0.8 allowed determination of XX/XY versus XY/XY gestations with 92.3-94.9% accuracy. Based on the data presented, MR may have utility in the analysis and interpretation of cfDNA data from multifetal gestations.
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Affiliation(s)
- Jill Rafalko
- Laboratory Corporation of America, La Jolla, California, United States of America
| | - Samantha Caldwell
- Laboratory Corporation of America, La Jolla, California, United States of America
| | - Erica Soster
- Laboratory Corporation of America, La Jolla, California, United States of America
| | - Eyad Almasri
- Laboratory Corporation of America, La Jolla, California, United States of America
| | - Graham McLennan
- Laboratory Corporation of America, La Jolla, California, United States of America
| | - Tong Liu
- Laboratory Corporation of America, La Jolla, California, United States of America
| | - Vivian Weinblatt
- Laboratory Corporation of America, La Jolla, California, United States of America
| | - Philip Cacheris
- Laboratory Corporation of America, La Jolla, California, United States of America
| | - Ron McCullough
- Laboratory Corporation of America, La Jolla, California, United States of America
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4
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Balaguer N, Mateu-Brull E, Naja RP, Nagi JB, Milán M. Chromosome Y as a marker for sex discrepancies in patients with organ transplants: a case report. Mol Cytogenet 2021; 14:3. [PMID: 33407713 PMCID: PMC7789569 DOI: 10.1186/s13039-020-00523-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/09/2020] [Indexed: 12/30/2022] Open
Abstract
Background Organ transplantations cause discrepancy in results from cell-free DNA (cfDNA) testing, but scientific literature is scarce. Case A 33-year old gravida underwent cfDNA testing, which showed high levels of Y chromosome (ChrY) in the maternal bloodstream. The ChrY pattern was comparable to an adult male reference. As a result, cfDNA testing was only informative for autosomes. Routine 20-week ultrasound scan showed no structural alterations and the presence of female external genitalia. Post-clinical research revealed that the patient received a bone marrow transplant from a male donor several years before. Fluorescence in situ hybridization showed that 100% of nuclei analysed from the patient’s lymphocytes presented a ChrY. Conclusion This case demonstrates ChrY can be used as a marker to avoid sex discrepancies in certain patients with organ transplants.
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Affiliation(s)
- Nuria Balaguer
- Igenomix Spain Lab S.L.U. Parque tecnológico, Ronda Narciso Monturiol, 11B. Edificios Europark, CP: 46980, Paterna, Valencia, Spain
| | - Emilia Mateu-Brull
- Igenomix Spain Lab S.L.U. Parque tecnológico, Ronda Narciso Monturiol, 11B. Edificios Europark, CP: 46980, Paterna, Valencia, Spain
| | - Roy P Naja
- Igenomix UK Ltd, Surrey Technology Centre, Guildford, UK
| | - Jara B Nagi
- The Centre for Reproductive & Genetic Health, London, UK
| | - Miguel Milán
- Igenomix Spain Lab S.L.U. Parque tecnológico, Ronda Narciso Monturiol, 11B. Edificios Europark, CP: 46980, Paterna, Valencia, Spain.
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5
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Balaguer N, Mateu-Brull E, Serra V, Simón C, Milán M. Should vanishing twin pregnancies be systematically excluded from cell-free fetal DNA testing? Prenat Diagn 2020; 41:1241-1248. [PMID: 32835421 DOI: 10.1002/pd.5817] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To demonstrate the feasibility of cell-free DNA (cfDNA) testing in vanishing twin (VT) pregnancies in routine clinical practice. METHODS Our study included 24 874 singleton and 206 VT consecutive pregnancies. Cell-free DNA was analyzed by massively parallel sequencing. Both aneuploidy analysis (chromosomes 13,18, 21, X, and Y) and fetal fraction estimation were performed according to an Illumina algorithm. Contaminant DNA contribution from the demised co-twin was studied in detail. RESULTS VT pregnancies exhibited a higher prevalence of screen-positive cases (5.8% vs 2.5%), sex discrepancies (10.2% vs 0.05%), and false positive rates (FPR) (2.6% vs 0.3%) than singleton pregnancies. However, their incidence was significantly lower in tests performed after the 14th week (screen-positive cases: 3.1%; sex discrepancies: 7.8%; and FPR: 0.8%). Among the 12 cases in which cfDNA was performed at two time points, fading of contaminating cfDNA was observed in four cases with a sex discrepancy and in one false positive for trisomy 18, resulting in a final correct result. CONCLUSIONS Our data suggest VT pregnancies could be included in cfDNA testing as long as it is applied after the 14th week of pregnancy. However, future studies to validate our findings are needed before including VT cases in routine clinical practice. Once established, unnecessary invasive procedures could be avoided, mitigating negative emotional impact on future mothers.
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Affiliation(s)
| | | | - Vicente Serra
- Maternal-Foetal Medicine Unit, Valencian University Institute of Infertility (IVIRMA), Valencia, Spain.,Department of Obstetrics & Gynecology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Carlos Simón
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Igenomix S.L., Valencia, Spain.,Beth Israel Deaconess Medical Center, Harvard University, Boston, Massachusetts, USA.,Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, Texas, USA
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6
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Bowman‐Smart H, Savulescu J, Gyngell C, Mand C, Delatycki MB. Sex selection and non-invasive prenatal testing: A review of current practices, evidence, and ethical issues. Prenat Diagn 2020; 40:398-407. [PMID: 31499588 PMCID: PMC7187249 DOI: 10.1002/pd.5555] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/02/2019] [Accepted: 08/25/2019] [Indexed: 12/24/2022]
Abstract
Non-invasive prenatal testing (NIPT) can determine the sex of the fetus very accurately and very early in gestation. There are concerns that the ease, timing, and accuracy of NIPT sex determination will facilitate sex-selective termination of pregnancy (TOP). Here, we review current practices, the evidence for a link between NIPT and sex-selective TOP, and associated ethical issues. Sex-selective TOP, usually motivated by son preference, has had serious demographic consequences in countries such as India and China. Currently, ultrasound is the primary method by which parents determine the sex of the fetus. The diffusion of ultrasound technology has had a direct impact on the rates of sex-selective TOP. Although NIPT is currently more costly, it is feasible that increased uptake of this technology could have a similar effect. Partly because NIPT is a relatively recent development in prenatal screening, there is little data on the impact of NIPT on sex selection practices. Evidence that NIPT is playing a role in sex-selective TOP remains largely anecdotal. Further research is required to assess and quantify TOP resulting from NIPT sex determination. The use of these technologies for sex selection raises a number of ethical issues, in addition to practical demographic consequences.
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Affiliation(s)
- Hilary Bowman‐Smart
- Bruce Lefroy CentreMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
| | - Julian Savulescu
- Bruce Lefroy CentreMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Uehiro Centre for Practical EthicsUniversity of OxfordOxfordUK
| | - Christopher Gyngell
- Bruce Lefroy CentreMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
| | - Cara Mand
- Bruce Lefroy CentreMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Martin B. Delatycki
- Bruce Lefroy CentreMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneVictoriaAustralia
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Jiang F, Yang X, He X, Yang M. Circulating DNA, a Potentially Sensitive and Specific Diagnostic Tool for Future Medicine. Dose Response 2019; 17:1559325819891010. [PMID: 31827416 PMCID: PMC6886285 DOI: 10.1177/1559325819891010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/21/2019] [Accepted: 10/24/2019] [Indexed: 11/28/2022] Open
Abstract
Liquid biopsy has the great potential of detecting early diseases before deterioration and is valued for screening abnormalities at early stage. In oncology, circulating DNA derived from shed cancer cells reflects the tissue of origin, so it could be used to locate tissue sites during early screening. However, the heterogenous parameters of different types limit the clinical application, making it inaccessible to encompass all the cancer types. Instead, for reproducible scenario as pregnancy, fetal cell-free DNA has been well utilized for screening aneuploidies. Noninvasive and convenient as is, it would be of great value in the next decades far more than early diagnosis. This review recapitulates the discovery and development of tumor and fetal cell-free DNA. The common factors are also present that could be taken into consideration when collecting, transporting, and preserving samples. Meanwhile, several protocols used for purifying cell-free DNA, either classic ones or through commercial kits, are compared carefully. In addition, the development of technologies for analyzing cell-free DNA have been summarized and discussed in detail, especially some up-to-date approaches. At the end, the potential prospect of circulating DNA is bravely depicted. In summary, although there would be a lot of efforts before it’s prevalent, cell-free DNA remains a promising tool in point-of-care diagnostic medicine.
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Affiliation(s)
- Fan Jiang
- Department of Rehabilitation Medicine, The First People's Hospital of Wenling, Wenzhou Medical University, Wenling, Zhejiang, China
| | - Xiaoxiao Yang
- Department of Rehabilitation Medicine, The First People's Hospital of Wenling, Wenzhou Medical University, Wenling, Zhejiang, China
| | - Xiping He
- Department of Rehabilitation Medicine, The First People's Hospital of Wenling, Wenzhou Medical University, Wenling, Zhejiang, China
| | - Mingming Yang
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Chen M, Jiang F, Guo Y, Yan H, Wang J, Zhang L, Zeng X, Li S, Li Y, Li N, Zhang C, Zhu W, Du B, Wang Y, Lan Z, Luo X, Luo F, Chen D. Validation of fetal DNA fraction estimation and its application in noninvasive prenatal testing for aneuploidy detection in multiple pregnancies. Prenat Diagn 2019; 39:1273-1282. [PMID: 31671222 DOI: 10.1002/pd.5597] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 07/12/2019] [Accepted: 09/15/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To analyze the fetal fraction, fetal sex, and chromosomal aneuploidy in multiple pregnancies using noninvasive prenatal testing (NIPT). METHOD A total of 362 pregnant women including 203 singleton pregnancies, 69 twins, and 90 higher-order multiple pregnancies were recruited. Fetal fractions estimated by size ratio-based and Y chromosome-based approaches in singleton pregnancies with male fetus were used as source data to establish the model. The model was then applied to multiple pregnancies for fetal fraction estimation. By comparing the fetal fractions estimated by size ratio to those estimated by Y chromosome or autosomal chromosomes, fetal sex and chromosomal aneuploidy can be analyzed. RESULTS The size ratio-based approach has been well established in estimating fetal fractions for twin and higher-order multiple pregnancies. Fetal fraction had a positive correlation with gestational age in twin and triplet pregnancies. Fetal sex was determined with accuracies of 98.6% (95% CI, 92.19%-99.96%) in twins and 97.6% (95% CI, 91.76%-99.71%) in triplet pregnancies. Four trisomy 21, one trisomy 18, and one trisomy 13 cases were detected by NIPT. Two trisomy 21 singleton pregnancies and one trisomy 21 twin pregnancy were confirmed by karyotyping. CONCLUSION Fetal sex and chromosomal aneuploidy in multiple pregnancies can be determined using NIPT.
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Affiliation(s)
- Min Chen
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics & Gynecology Institute of Guangzhou, Guangzhou, China.,The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.,Key Laboratory for Reproduction and Genetics of Guangdong Higher Education Institutes, Guangzhou, China
| | - Fuman Jiang
- School of Automation Science and Engineering, South China University of Technology, Guangzhou, China.,Guangzhou Jingke Medical Laboratory, Guangzhou, China.,Shenzhen Jingke Genetic Science and Technology Co., Ltd., Shenzhen, China
| | - Yulai Guo
- Guangzhou Jingke Medical Laboratory, Guangzhou, China
| | - Huanchen Yan
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics & Gynecology Institute of Guangzhou, Guangzhou, China.,The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.,Key Laboratory for Reproduction and Genetics of Guangdong Higher Education Institutes, Guangzhou, China
| | - Jiayan Wang
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics & Gynecology Institute of Guangzhou, Guangzhou, China.,The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.,Key Laboratory for Reproduction and Genetics of Guangdong Higher Education Institutes, Guangzhou, China
| | - Longmei Zhang
- Guangzhou Jingke Medical Laboratory, Guangzhou, China
| | - XiaoJing Zeng
- Guangzhou Jingke Medical Laboratory, Guangzhou, China
| | - Sheng Li
- Guangzhou Jingke Medical Laboratory, Guangzhou, China
| | - Yufan Li
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics & Gynecology Institute of Guangzhou, Guangzhou, China.,The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.,Key Laboratory for Reproduction and Genetics of Guangdong Higher Education Institutes, Guangzhou, China
| | - Nan Li
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics & Gynecology Institute of Guangzhou, Guangzhou, China.,The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.,Key Laboratory for Reproduction and Genetics of Guangdong Higher Education Institutes, Guangzhou, China
| | | | - Wentao Zhu
- Guangzhou Jingke Medical Laboratory, Guangzhou, China
| | - Bole Du
- Guangzhou Jingke Medical Laboratory, Guangzhou, China
| | - Yang Wang
- Guangzhou Jingke Medical Laboratory, Guangzhou, China
| | - Zhiheng Lan
- Guangzhou Jingke Medical Laboratory, Guangzhou, China
| | - Xingcheng Luo
- Guangzhou Jingke Medical Laboratory, Guangzhou, China
| | - Fei Luo
- School of Automation Science and Engineering, South China University of Technology, Guangzhou, China
| | - Dunjin Chen
- Obstetrics & Gynecology Institute of Guangzhou, Guangzhou, China.,The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.,Key Laboratory for Reproduction and Genetics of Guangdong Higher Education Institutes, Guangzhou, China
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Villela D, Che H, Van Ghelue M, Dehaspe L, Brison N, Van Den Bogaert K, Devriendt K, Lewi L, Bayindir B, Vermeesch JR. Fetal sex determination in twin pregnancies using non-invasive prenatal testing. NPJ Genom Med 2019; 4:15. [PMID: 31285848 PMCID: PMC6609680 DOI: 10.1038/s41525-019-0089-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 05/31/2019] [Indexed: 01/23/2023] Open
Abstract
Non-invasive prenatal testing (NIPT) is accurate for fetal sex determination in singleton pregnancies, but its accuracy is not well established in twin pregnancies. Here, we present an accurate sex prediction model to discriminate fetal sex in both dichorionic diamniotic (DCDA) and monochorionic diamniotic/monochorionic monoamniotic (MCDA/MCMA) twin pregnancies. A retrospective analysis was performed using a total of 198 twin pregnancies with documented sex. The prediction was based on a multinomial logistic regression using the normalized frequency of X and Y chromosomes, and fetal fraction estimation. A second-step regression analysis was applied when one or both twins were predicted to be male. The model determines fetal sex with 100% sensitivity and specificity when both twins are female, and with 98% sensitivity and 95% specificity when a male is present. Since sex determination can be clinically important, implementing fetal sex determination in twins will improve overall twin pregnancies management.
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Affiliation(s)
- Darine Villela
- 1Department of Human Genetics, KU Leuven, Leuven, Belgium.,2Department of Genetics and Evolutionary Biology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | - Huiwen Che
- 1Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Marijke Van Ghelue
- 1Department of Human Genetics, KU Leuven, Leuven, Belgium.,3Department of Medical Genetics, Division of Child and Adolescent Health, University Hospital of North Norway, Tromsø, Norway.,4Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Luc Dehaspe
- 1Department of Human Genetics, KU Leuven, Leuven, Belgium
| | | | | | - Koen Devriendt
- 1Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Liesbeth Lewi
- 5Clinical Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,6Department of Development and Regeneration, Cluster Woman and Child, Group Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Baran Bayindir
- 1Department of Human Genetics, KU Leuven, Leuven, Belgium
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