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Evaluation of chromosomal abnormalities and copy number variations in fetuses with ultrasonic soft markers. BMC Med Genomics 2021; 14:19. [PMID: 33435955 PMCID: PMC7802188 DOI: 10.1186/s12920-021-00870-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background Some ultrasonic soft markers can be found during ultrasound examination. However, the etiology of the fetuses with ultrasonic soft markers is still unknown. This study aimed to evaluate the genetic etiology and clinical value of chromosomal abnormalities and copy number variations (CNVs) in fetuses with ultrasonic soft markers. Methods Among 1131 fetuses, 729 had single ultrasonic soft marker, 322 had two ultrasonic soft markers, and 80 had three or more ultrasonic soft markers. All fetuses underwent conventional karyotyping, followed by single nucleotide polymorphism (SNP) array analysis. Results Among 1131 fetuses with ultrasonic soft markers, 46 had chromosomal abnormalities. In addition to the 46 fetuses with chromosomal abnormalities consistent with the results of the karyotyping analysis, the SNP array identified additional 6.1% (69/1131) abnormal CNVs. The rate of abnormal CNVs in fetuses with ultrasonic soft marker, two ultrasonic soft markers, three or more ultrasonic soft markers were 6.2%, 6.2%, and 5.0%, respectively. No significant difference was found in the rate of abnormal CNVs among the groups. Conclusions Genetic abnormalities affect obstetrical outcomes. The SNP array can fully complement conventional karyotyping in fetuses with ultrasonic soft markers, improve detection rate of chromosomal abnormalities, and affect pregnancy outcomes.
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Gross MS, Ju H, Osborne LM, Jelin EB, Sekar P, Jelin AC. Indeterminate Prenatal Ultrasounds and Maternal Anxiety: A Prospective Cohort Study. Matern Child Health J 2021; 25:802-812. [PMID: 33392932 DOI: 10.1007/s10995-020-03042-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Prenatal ultrasounds often yield indeterminate (incomplete or minor abnormality) findings with limited clinical utility. We evaluate impact of indeterminate findings on maternal anxiety. METHODS A single-U.S.-center prospective cohort study administered the Perinatal Anxiety Screening Scale (PASS; control mean = 13.4; > 20 denotes clinically significant anxiety) before and after prenatal ultrasounds in February-May 2017. Ultrasound reports were coded as: normal; indeterminate; or major abnormality. Primary outcome was anxiety after indeterminate vs. normal ultrasounds. Secondary outcomes included anxiety change from pre-to-post-ultrasound and relative to women's characteristics. Linear regression adjusted for confounders. RESULTS Of 286 ultrasounds, 51.0% were normal, 40.5% indeterminate (22.0% incomplete; 18.5% minor abnormality), and 8.0% major abnormalities. Indeterminate findings were unrelated to age, race, parity, infertility, or psychiatric history, but associated with gestational age (26.6%/45.0%/52.5% for first/second/third trimesters; p < 0.001), and obesity (48.8 vs. 37.0%; p = 0.031). Pretest anxiety was highest in second/third trimesters (p = 0.029), and in subjects aged age ≤ 24 or younger(p < 0.001), with a history of anxiety (p < 0.001),) or with prior pregnancy loss (p = 0.011). Mean anxiety score decreased pre-to-posttest across all groups. Indeterminate findings were associated with higher PASS scores than normal findings: pretest 20.1 vs. 16.4 (p = 0.026) and posttest 16.9 vs. 12.2 (p = 0.009; adjusted-p = 0.01). Versus normal ultrasounds, incomplete findings were associated with higher post-ultrasound anxiety (p = 0.007; adjusted-p = 0.01) and smaller decreases from pre-to-posttest (adjusted-p = 0.03), whereas minor abnormalities had higher pretest anxiety (p = 0.029) with larger pre-to-posttest decreases (adjusted-p =0.010). DISCUSSION Indeterminate ultrasounds, especially incomplete findings, are associated with significantly higher anxiety than normal findings, suggesting need for evidence-based counseling, management and strategies for decreasing number of indeterminate results.
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Affiliation(s)
- Marielle S Gross
- Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Ave, Baltimore, MD, 21205, USA. .,Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Women's Mood Disorders Center, 550 N. Broadway, Suite 305, Baltimore, MD, 21205, USA. .,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, 15222, USA.
| | - Hyeyoung Ju
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Women's Mood Disorders Center, 550 N. Broadway, Suite 305, Baltimore, MD, 21205, USA
| | - Lauren M Osborne
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Women's Mood Disorders Center, 550 N. Broadway, Suite 305, Baltimore, MD, 21205, USA.,Psychiatry and Behavioral Sciences, Women's Mood Disorders Center, 550 N. Broadway, Suite 305, Baltimore, MD, 21205, USA
| | - Eric B Jelin
- Children's Center Fetal Program, Johns Hopkins Children's Center, 1800 Orleans Street, Baltimore, MD, M230721287, USA
| | - Priya Sekar
- Pediatric Cardiology, Johns Hopkins Children's Center, 1800 Orleans Street, Baltimore, MD, M230721287, USA
| | - Angie C Jelin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Women's Mood Disorders Center, 550 N. Broadway, Suite 305, Baltimore, MD, 21205, USA
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