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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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Popescu-Hobeanu G, Riza AL, Streață I, Tudorache Ș, Comănescu A, Tănase F, Drăgușin RC, Pascu C, Dijmărescu AL, Cara ML, Dorobanțu Ș, Petre-Mandache B, Cucu M, Sosoi SS, Ioana M, Iliescu D, Burada F. Cytogenetic Analysis of Sporadic First-Trimester Miscarriage Specimens Using Karyotyping and QF-PCR: A Retrospective Romanian Cohort Study. Genes (Basel) 2022; 13:genes13122246. [PMID: 36553513 PMCID: PMC9778060 DOI: 10.3390/genes13122246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/17/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
It is well known that first-trimester miscarriages are associated with chromosome abnormalities, with numerical chromosome abnormalities being the ones most commonly detected. Conventional karyotyping is still considered the gold standard in the analysis of products of conception, despite the extended use of molecular genetic techniques. However, conventional karyotyping is a laborious and time-consuming method, with a limited resolution of 5-10 Mb and hampered by maternal cell contamination and culture failure. The aim of our study was to assess the type and frequency of chromosomal abnormalities detected by conventional karyotyping in specimens of sporadic first-trimester miscarriages in a Romanian cohort, using QF-PCR to exclude maternal cell contamination. Long-term cultures were established and standard protocols were applied for cell harvesting, slide preparation, and GTG banding. All samples with 46,XX karyotype were tested for maternal cell contamination by QF-PCR, comparing multiple microsatellite markers in maternal blood with cell culture and tissue samples. Out of the initial 311 specimens collected from patients with sporadic first-trimester miscarriages, a total of 230 samples were successfully analyzed after the exclusion of 81 specimens based on unsuitable sampling, culture failure, or QF-PCR-proven maternal cell contamination. Chromosome abnormalities were detected in 135 cases (58.7%), with the most common type being single autosomal trisomy (71/135-52.6%), followed by monosomy (monosomy X being the only one detected, 24/135-17.8%), and polyploidy (23/135-17.0%). The subgroup analysis based on maternal age showed a statistically significant higher rate of single trisomy for women aged 35 years or older (40.3%) compared to the young maternal age group (26.1%) (p = 0.029). In conclusion, the combination of conventional karyotyping and QF-PCR can lead to an increased chromosome abnormality detection rate in first-trimester miscarriages. Our study provides reliable information for the genetic counseling of patients with first-trimester miscarriages, and further large-scale studies using different genetic techniques are required.
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Affiliation(s)
- Gabriela Popescu-Hobeanu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
| | - Anca-Lelia Riza
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
- Regional Centre of Medical Genetics Dolj, Emergency Clinical County Hospital Craiova, 200642 Craiova, Romania
| | - Ioana Streață
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
- Regional Centre of Medical Genetics Dolj, Emergency Clinical County Hospital Craiova, 200642 Craiova, Romania
- Correspondence: (I.S.); (Ș.T.)
| | - Ștefania Tudorache
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, Romania
- Correspondence: (I.S.); (Ș.T.)
| | - Alexandru Comănescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, Romania
| | - Florentina Tănase
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, Romania
| | - Roxana Cristina Drăgușin
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, Romania
| | | | - Anda Lorena Dijmărescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Obstetrics and Gynecology, Clinical Municipal Hospital “Filantropia” of Craiova, 200143 Craiova, Romania
| | - Monica-Laura Cara
- Regional Centre of Medical Genetics Dolj, Emergency Clinical County Hospital Craiova, 200642 Craiova, Romania
- Department of Public Health, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ștefania Dorobanțu
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
- Regional Centre of Medical Genetics Dolj, Emergency Clinical County Hospital Craiova, 200642 Craiova, Romania
| | - Bianca Petre-Mandache
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
| | - Mihai Cucu
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
- Regional Centre of Medical Genetics Dolj, Emergency Clinical County Hospital Craiova, 200642 Craiova, Romania
| | - Simona Serban Sosoi
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
- Regional Centre of Medical Genetics Dolj, Emergency Clinical County Hospital Craiova, 200642 Craiova, Romania
| | - Mihai Ioana
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
- Regional Centre of Medical Genetics Dolj, Emergency Clinical County Hospital Craiova, 200642 Craiova, Romania
| | - Dominic Iliescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Obstetrics and Gynecology, Emergency Clinical County Hospital, 200642 Craiova, Romania
| | - Florin Burada
- Laboratory of Human Genomics, University of Medicine and Pharmacy of Craiova, 200638 Craiova, Romania
- Regional Centre of Medical Genetics Dolj, Emergency Clinical County Hospital Craiova, 200642 Craiova, Romania
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Ouchi N, Takeshita T, Kasano S, Yokote R, Yonezawa M, Kurashina R, Ichikawa T, Kawabata I, Kuwabara Y, Suzuki S. Maternal cell contamination in embryonic chromosome analysis of missed abortions. J Obstet Gynaecol Res 2022; 48:1641-1647. [DOI: 10.1111/jog.15249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Nozomi Ouchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
| | - Toshiyuki Takeshita
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
| | - Sayuri Kasano
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
| | - Ryoko Yokote
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
| | - Mirei Yonezawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
| | - Ryuhei Kurashina
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
| | - Tomoko Ichikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
| | - Ikuno Kawabata
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
| | - Yoshimitsu Kuwabara
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
| | - Shunji Suzuki
- Department of Obstetrics and Gynecology, Graduate School of Medicine Nippon Medical School Tokyo Japan
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