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Miyagami K, Shirato N, Izumi M, Hirose T, Yasui O, Hamada S, Matsuoka R, Suzumori N, Sekizawa A. Prenatal Identification of Confined Placental Mosaicism in Pregnant Women with Fetal Growth Restriction. Reprod Sci 2021; 29:896-903. [PMID: 34713432 DOI: 10.1007/s43032-021-00772-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/09/2021] [Indexed: 11/30/2022]
Abstract
We examined the influence of confined placental mosaicism (CPM) as a cause of fetal growth restriction (FGR), and whether CPM can be screened using cell-free DNA (cfDNA) analysis of the maternal plasma. We analyzed cfDNA in the maternal plasma of 40 FGR cases with an estimated fetal weight of less than - 2.0 SD using massively parallel sequencing to detect chromosomal aberrations. Fetal and placental genotyping was performed to confirm CPM cases. cfDNA analyses of maternal plasma detected suspected CPM cases with chromosomal aneuploidy or copy number variations in 5 of 40 cases (12.5%). For 4 cases in which the entire placenta consisted of cells with chromosomal abnormalities, fetal growth was severely restricted. CPM can be screened by cfDNA analysis in maternal plasma, accounting for approximately 10% of the causes of moderate or severe FGR, and the higher the proportion of abnormal karyotype cells in the placenta, the more severe the placental dysfunction and FGR.
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Affiliation(s)
- Keiko Miyagami
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Nahoko Shirato
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Mikiko Izumi
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Tatsuko Hirose
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Osamu Yasui
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Shoko Hamada
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Ryu Matsuoka
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Nobuhiro Suzumori
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Akihiko Sekizawa
- Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
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Suzumori N, Sekizawa A, Takeda E, Samura O, Sasaki A, Akaishi R, Wada S, Hamanoue H, Hirahara F, Sawai H, Nakamura H, Yamada T, Miura K, Masuzaki H, Nakayama S, Kamei Y, Namba A, Murotsuki J, Yamaguchi M, Tairaku S, Maeda K, Kaji T, Okamoto Y, Endo M, Ogawa M, Kasai Y, Ichizuka K, Yamada N, Ida A, Miharu N, Kawaguchi S, Hasuo Y, Okazaki T, Ichikawa M, Izumi S, Kuno N, Yotsumoto J, Nishiyama M, Shirato N, Hirose T, Sago H. Retrospective details of false-positive and false-negative results in non-invasive prenatal testing for fetal trisomies 21, 18 and 13. Eur J Obstet Gynecol Reprod Biol 2020; 256:75-81. [PMID: 33171421 DOI: 10.1016/j.ejogrb.2020.10.050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 10/16/2020] [Accepted: 10/23/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Maternal characteristics and neonatal outcomes associated with cell-free DNA (cfDNA) results were analysed retrospectively to assess the details of false-positive and false-negative results after initial blood sampling in non-invasive prenatal testing (NIPT). STUDY DESIGN A multicentre retrospective study was performed for women undergoing NIPT who received discordant cfDNA results between April 2013 and March 2018. The NIPT data obtained using massive parallel sequencing were studied in terms of maternal background, fetal fraction, z-scores, invasive procedure results and neonatal outcomes after birth. RESULTS Of the 56,545 women who participated in this study, 54 false-positive (0.095 %) and three false-negative (0.006 %) cases were found. Seven of the 54 false-positive cases (13.0 %) had vanishing twin on ultrasonography. Among the 18 false-positive cases of trisomy 18, confined placental mosaicism (CPM) was confirmed in three cases (16.7 %), while CPM was present in one of the three false-negative cases of trisomy 21. CONCLUSION These data suggest that the incidence of women with false-positive or false-negative results is relatively low, that such false results can often be explained, and that vanishing twin and CPM are potential causes of NIPT failure. Genetic counselling with regard to false results is important for clients prior to undergoing NIPT.
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Affiliation(s)
- Nobuhiro Suzumori
- Department of Obstetrics and Gynaecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Division of Clinical and Molecular Genetics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| | - Akihiko Sekizawa
- Department of Obstetrics and Gynaecology, Showa University School of Medicine, Tokyo, Japan
| | - Eri Takeda
- Department of Obstetrics and Gynaecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Division of Clinical and Molecular Genetics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Osamu Samura
- Department of Obstetrics and Gynaecology, Jikei University School of Medicine, Tokyo, Japan
| | - Aiko Sasaki
- Centre for Maternal-Fetal, Neonatal and Reproductive Medicine, National Centre for Child Health and Development, Tokyo, Japan
| | - Rina Akaishi
- Centre for Maternal-Fetal, Neonatal and Reproductive Medicine, National Centre for Child Health and Development, Tokyo, Japan
| | - Seiji Wada
- Centre for Maternal-Fetal, Neonatal and Reproductive Medicine, National Centre for Child Health and Development, Tokyo, Japan
| | - Haruka Hamanoue
- Department of Clinical Genetics, Yokohama City University Hospital, Yokohama, Japan
| | - Fumiki Hirahara
- Department of Clinical Genetics, Yokohama City University Hospital, Yokohama, Japan
| | - Hideaki Sawai
- Department of Obstetrics and Gynaecology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hiroaki Nakamura
- Department of Obstetrics, Osaka City General Hospital, Osaka, Japan
| | - Takahiro Yamada
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto, Japan
| | - Kiyonori Miura
- Department of Obstetrics and Gynaecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideaki Masuzaki
- Department of Obstetrics and Gynaecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Setsuko Nakayama
- Boshi-Aiikukai Maternal & Child Health Center, Aiiku Clinic, Tokyo, Japan
| | - Yoshimasa Kamei
- Departments of Obstetrics and Gynaecology, Saitama Medical University School of Medicine, Saitama, Japan
| | - Akira Namba
- Departments of Obstetrics and Gynaecology, Saitama Medical University School of Medicine, Saitama, Japan
| | - Jun Murotsuki
- Department of Maternal and Fetal Medicine, Tohoku University Graduate School of Medicine, Miyagi Children's Hospital, Sendai, Japan
| | - Masayuki Yamaguchi
- Department of Obstetrics and Gynaecology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Shinya Tairaku
- Department of Obstetrics and Gynaecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuhisa Maeda
- Department of Obstetrics and Gynaecology, Shikoku Medical Centre for Children and Adults, Kagawa, Japan
| | - Takashi Kaji
- Department of Obstetrics and Gynaecology, The University of Tokushima Faculty of Medicine, Tokushima, Japan
| | - Yoko Okamoto
- Department of Obstetrics, Osaka Women's and Child's Hospital, Osaka, Japan
| | - Masayuki Endo
- Department of Obstetrics and Gynaecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Ogawa
- Department of Obstetrics and Gynaecology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yasuyo Kasai
- Department of Obstetrics and Gynaecology, Japanese Red Cross Medical Centre, Tokyo, Japan
| | - Kiyotake Ichizuka
- Department of Obstetrics and Gynaecology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Naoki Yamada
- Departments of Obstetrics and Gynaecology, Mito Saiseikai General Hospital, Ibaraki, Japan
| | - Akinori Ida
- Department of Obstetrics and Gynaecology, Kobe Adventist Hospital, Kobe, Japan
| | - Norio Miharu
- Department of Obstetrics and Gynaecology, Chugokudenryoku Hospital, Hiroshima, Japan
| | - Satoshi Kawaguchi
- Department of Obstetrics and Gynaecology, Hokkaido University Hospital, Hokkaido, Japan
| | - Yasuyuki Hasuo
- Department of Obstetrics and Gynaecology, National Hospital Organization, Kyushu Medical Centre, Fukuoka, Japan
| | - Tetsuya Okazaki
- Division of Clinical Genetics, Tottori University Hospital, Yonago, Japan
| | - Mayuko Ichikawa
- Department of Obstetrics and Gynaecology, Nara Medical University, Nara, Japan
| | - Shunichiro Izumi
- Department of Obstetrics and Gynaecology, Tokai University, Isehara, Japan
| | - Naohiko Kuno
- Department of Obstetrics and Gynaecology, AOI Nagoya Hospital, Nagoya, Japan
| | - Junko Yotsumoto
- Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tokyo, Japan
| | - Miyuki Nishiyama
- Centre for Maternal-Fetal, Neonatal and Reproductive Medicine, National Centre for Child Health and Development, Tokyo, Japan
| | - Nahoko Shirato
- Department of Obstetrics and Gynaecology, Showa University School of Medicine, Tokyo, Japan
| | - Tatsuko Hirose
- Department of Obstetrics and Gynaecology, Showa University School of Medicine, Tokyo, Japan
| | - Haruhiko Sago
- Centre for Maternal-Fetal, Neonatal and Reproductive Medicine, National Centre for Child Health and Development, Tokyo, Japan
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