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Cell-Free DNA Screening for Sex Chromosome Abnormalities and Pregnancy Outcomes, 2018-2020: A Retrospective Analysis. J Pers Med 2022; 12:jpm12010048. [PMID: 35055363 PMCID: PMC8780735 DOI: 10.3390/jpm12010048] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 12/22/2022] Open
Abstract
To evaluate the efficacy of non-invasive prenatal screening (NIPT) for detecting fetal sex chromosome abnormalities, a total of 639 women carrying sex chromosome abnormalities were selected from 222,107 pregnant women who participated in free NIPT from April 2018 to December 2020. The clinical data, prenatal diagnosis results, and follow-up pregnancy outcomes of participants were collected. The positive predictive value (PPV) was used to analyze the performance of NIPT. Around 235 cases were confirmed with sex chromosome abnormalities, including 229 cases with sex chromosome aneuploidy (45, X (n = 37), 47, XXX (n = 37), 47, XXY (n = 110), 47, XYY (n = 42)) and 6 cases with structural abnormalities. The total incidence rate was 0.11% (235/222,107). The PPV of NIPT was 45.37% (235/518). NIPT accuracy for detecting sex chromosome polysomes was higher than that for sex chromosome monomers. The termination of pregnancy rate for fetal diagnosis of 45, X, and 47, XXY was higher than that of 47, XXX, and 47, XYY. The detection rate of fetal sex chromosome abnormalities was higher in 2018–2020 than in 2010–2012 (χ2 = 69.708, P < 2.2 × 10−16), indicating that NIPT is greatly efficient to detect fetal sex chromosome abnormalities.
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Zhong A, Darren B, Loiseau B, He LQB, Chang T, Hill J, Dimaras H. Ethical, social, and cultural issues related to clinical genetic testing and counseling in low- and middle-income countries: a systematic review. Genet Med 2018; 23:2270-2280. [PMID: 30072741 DOI: 10.1038/s41436-018-0090-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 06/04/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE We performed a systematic review of the ethical, social, and cultural issues associated with delivery of genetic services in low- and middle-income countries (LMICs). METHODS We searched 11 databases for studies addressing ethical, social, and/or cultural issues associated with clinical genetic testing and/or counselling performed in LMICs. Narrative synthesis was employed to analyze findings, and resultant themes were mapped onto the social ecological model (PROSPERO #CRD42016042894). RESULTS After reviewing 13,308 articles, 192 met inclusion criteria. Nine themes emerged: (1) genetic counseling has a tendency of being directive, (2) genetic services have psychosocial consequences that require improved support, (3) medical genetics training is inadequate, (4) genetic services are difficult to access, (5) social determinants affect uptake and understanding of genetic services, (6) social stigma is often associated with genetic disease, (7) family values are at risk of disruption by genetic services, (8) religious principles pose barriers to acceptability and utilization of genetic services, and (9) cultural beliefs and practices influence uptake of information and understanding of genetic disease. CONCLUSION We identified a number of complex and interrelated ethical, cultural, and social issues with implications implications for further development of genetic services in LMICs.
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Affiliation(s)
- Adrina Zhong
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Schulich School of Medicine & Dentistry, Western University, Canada
| | - Benedict Darren
- Human Biology Program, Faculty of Arts & Science, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bethina Loiseau
- Human Biology Program, Faculty of Arts & Science, University of Toronto, Toronto, ON, Canada
| | - Li Qun Betty He
- Human Biology Program, Faculty of Arts & Science, University of Toronto, Toronto, ON, Canada.,Michael G. DeGroote Medical School, McMaster University, Hamilton, ON, Canada
| | - Trillium Chang
- Human Biology Program, Faculty of Arts & Science, University of Toronto, Toronto, ON, Canada
| | - Jessica Hill
- Department of Molecular Genetics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Helen Dimaras
- Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. .,Department of Ophthalmology & Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. .,Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, Toronto, ON, Canada. .,Child Health Evaluative Sciences Program & The Centre for Global Child Health, SickKids Research Institute, Toronto, ON, Canada. .,Department of Human Pathology, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
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So PL, Cheng KYY, Cheuk KY, Chiu WK, Mak SL, Mok SL, Lo TK, Yung WK, Lo FM, Chung HYB, Kan SYA, Lee CP, Tang HYM. Parental decisions following prenatal diagnosis of sex chromosome aneuploidy in Hong Kong. J Obstet Gynaecol Res 2017; 43:1821-1829. [PMID: 28892214 DOI: 10.1111/jog.13451] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/18/2017] [Accepted: 06/17/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Po Lam So
- Department of Obstetrics and Gynaecology; Tuen Mun Hospital; Hong Kong SAR China
| | - Kwun Yue Yvonne Cheng
- Department of Obstetrics and Gynaecology; Prince of Wales Hospital; Hong Kong SAR China
| | - Kwan Yiu Cheuk
- Department of Obstetrics and Gynaecology; Pamela Youde Nethersole Eastern Hospital; Hong Kong SAR China
| | - Wan Kam Chiu
- Department of Obstetrics and Gynaecology; United Christian Hospital; Hong Kong SAR China
| | - Shui Lam Mak
- Department of Obstetrics and Gynaecology; Queen Elizabeth Hospital; Hong Kong SAR China
| | - Sau Lan Mok
- Department of Obstetrics and Gynaecology; Princess Margaret Hospital; Hong Kong SAR China
| | - Tsz Kin Lo
- Department of Obstetrics and Gynaecology; Queen Mary Hospital; Hong Kong SAR China
| | - Wai Kuen Yung
- Department of Obstetrics and Gynaecology; Kwong Wah Hospital; Hong Kong SAR China
| | - Fai Man Lo
- Clinical Genetic Service, Department of Health; Hong Kong SAR China
| | - Hon Yin Brian Chung
- Departments of Paediatrics and Adolescent Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Sik Yau Anita Kan
- Department of Obstetrics and Gynaecology; Queen Mary Hospital; Hong Kong SAR China
- Prenatal Diagnostic and Counselling Division; Tsan Yuk Hospital; Hong Kong SAR China
| | - Chin Peng Lee
- Prenatal Diagnostic and Counselling Division; Tsan Yuk Hospital; Hong Kong SAR China
- Department of Obstetrics and Gynaecology; The University of Hong Kong; Hong Kong SAR China
| | - Hoi Yin Mary Tang
- Prenatal Diagnostic and Counselling Division; Tsan Yuk Hospital; Hong Kong SAR China
- Department of Obstetrics and Gynaecology; The University of Hong Kong; Hong Kong SAR China
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