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Zhang S, Pei Z, Lei C, Bai Y, Wu J, Xiao M, Zhou J, Hu B, Chen S, Wu Y, Yang J, Sun X, Lu D, Xu C, Xu C. A novel noninvasive prenatal testing method for chromosomal rearrangements using maternal circulating cell-free foetal DNA. Clin Transl Med 2023; 13:e1160. [PMID: 36610059 PMCID: PMC9825107 DOI: 10.1002/ctm2.1160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 01/09/2023] Open
Affiliation(s)
- Shuo Zhang
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Zhenle Pei
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Caixia Lei
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Yixuan Bai
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Junping Wu
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Min Xiao
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Jing Zhou
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Bin Hu
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Songchang Chen
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Yiming Wu
- State Key Laboratory of Genetic EngineeringSchool of Life ScienceFudan UniversityShanghaiChina,NHC Key Laboratory of Birth Defects and Reproductive HealthChongqing Key Laboratory of Birth Defects and Reproductive HealthChongqing Population and Family PlanningScience and Technology Research InstituteChongqingChina
| | - Jingmin Yang
- State Key Laboratory of Genetic EngineeringSchool of Life ScienceFudan UniversityShanghaiChina,NHC Key Laboratory of Birth Defects and Reproductive HealthChongqing Key Laboratory of Birth Defects and Reproductive HealthChongqing Population and Family PlanningScience and Technology Research InstituteChongqingChina
| | - Xiaoxi Sun
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Daru Lu
- State Key Laboratory of Genetic EngineeringSchool of Life ScienceFudan UniversityShanghaiChina,NHC Key Laboratory of Birth Defects and Reproductive HealthChongqing Key Laboratory of Birth Defects and Reproductive HealthChongqing Population and Family PlanningScience and Technology Research InstituteChongqingChina
| | - Chenming Xu
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Congjian Xu
- Shanghai Ji Ai Genetics & IVF InstituteShanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina,Department of Obstetrics and Gynecology of Shanghai Medical SchoolFudan UniversityShanghaiChina
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Likar IP, Jere KS, Možina T, Verdenik I, Tul N. Pregnancy Loss After Amniocentesis and Chorionic Villus Sampling: Cohort Study. Zdr Varst 2020; 60:25-29. [PMID: 33488819 PMCID: PMC7780764 DOI: 10.2478/sjph-2021-0005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/19/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Introduction: To estimate the procedure-related risks of pregnancy loss following chorionic villus sampling (CVS) and amniocentesis (AC) compared to pregnancies without procedure. METHODS This cohort study enrolled all women who underwent CVS or AC at the Department of Perinatology, University Medical Centre, Ljubljana, Slovenia (from January 2013 to June 2015). For each group we obtained a maternal age and gestational age (11-14 weeks for CVS and >15 weeks for AC) for a matched control group without invasive procedures from the national database. The data was obtained from hospital records and telephone surveys concerning pregnancy outcomes. Pregnancy loss rates in intervention vs. control groups were compared by generating relative risk (RR) with a 95% confidence interval. RESULTS During the study period, 828 women underwent CVS and 2,164 women underwent AC. Complete outcome data was available in 2,798 cases (93.5%, 770 CVS, 2,028 AC). Pregnancy loss occurred in 8/770 (1.04%, 95% CI 0.4-2.0%) after CVS vs. 15/1130 (1.33%, 95% CI 0.8-2.2%) in matched control (RR 0.8, 95% CI 0.33-1.8, p=0.6). It occurred in 16/2028 (0.79%, 95% CI 0.5-1.3%) after AC vs. 14/395 (3.29%, 95% CI 2.1-5.8%) in matched control (RR 0.2, 95% CI 0.11-0.45, p<0.0001). CONCLUSION The pregnancy loss rates after CVS and AC were comparable to losses in pregnancies without these procedures. With the increasing use of non-invasive prenatal testing, information that the invasive procedures are safe when indicated is essential.
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Affiliation(s)
- Ivana Paljk Likar
- University Medical Centre Ljubljana, Department of Perinatology, Division of Obstetrics and Gynecology, Šlajmerjeva ulica 3, 1000Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000Ljubljana, Slovenia
| | - Ksenija Slavec Jere
- University Medical Centre Ljubljana, Department of Perinatology, Division of Obstetrics and Gynecology, Šlajmerjeva ulica 3, 1000Ljubljana, Slovenia
| | - Teja Možina
- University Medical Centre Ljubljana, Department of Perinatology, Division of Obstetrics and Gynecology, Šlajmerjeva ulica 3, 1000Ljubljana, Slovenia
| | - Ivan Verdenik
- University Medical Centre Ljubljana, Department of Perinatology, Division of Obstetrics and Gynecology, Šlajmerjeva ulica 3, 1000Ljubljana, Slovenia
| | - Nataša Tul
- Women’s Hospital Postojna, Prečna ulica 4, 6230Postojna, Slovenia
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Witt RG, Blair L, Frascoli M, Rosen MJ, Nguyen QH, Bercovici S, Zompi S, Romero R, Mackenzie TC. Detection of microbial cell-free DNA in maternal and umbilical cord plasma in patients with chorioamnionitis using next generation sequencing. PLoS One 2020; 15:e0231239. [PMID: 32294121 PMCID: PMC7159194 DOI: 10.1371/journal.pone.0231239] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/19/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Chorioamnionitis has been linked to spontaneous preterm labor and complications such as neonatal sepsis. We hypothesized that microbial cell-free (cf) DNA would be detectable in maternal plasma in patients with chorioamnionitis and could be the basis for a non-invasive method to detect fetal exposure to microorganisms. OBJECTIVE The purpose of this study was to determine whether next generation sequencing could detect microbial cfDNA in maternal plasma in patients with chorioamnionitis. STUDY DESIGN Maternal plasma (n = 94) and umbilical cord plasma (n = 120) were collected during delivery at gestational age 28-41 weeks. cfDNA was extracted and sequenced. Umbilical cord plasma samples with evidence of contamination were excluded. The prevalence of microorganisms previously implicated in choriomanionitis, neonatal sepsis and intra-amniotic infections, as described in the literature, were examined to determine if there was enrichment of these microorganisms in this cohort. Specific microbial cfDNA associated with chorioamnionitis was first detected in umbilical cord plasma and confirmed in the matched maternal plasma samples (n = 77 matched pairs) among 14 cases of histologically confirmed chorioamnionitis and one case of clinical chorioamnionitis; 63 paired samples were used as controls. A correlation of rank of a given microorganism across maternal plasma and matched umbilical cord plasma was used to assess whether signals found in umbilical cord plasma were also present in maternal plasma. RESULTS Microbial DNA sequences associated with clinical and/or histological chorioamnionitis were enriched in maternal plasma in cases with suspected chorioamnionitis when compared to controls (12/14 microorganisms, p = 0.02). Analysis of the microbial cfDNA in umbilical cord plasma among the 1,251 microorganisms detectable with this assay identified Streptococcus mitis, Ureaplasma spp., and Mycoplasma spp. in cases of suspected chorioamnionitis. This assay also detected cfDNA from Lactobacillus spp. in controls. Comparison between maternal plasma and umbilical cord plasma confirmed these signatures were also present in maternal plasma. Unbiased analysis of microorganisms with significantly correlated signal between matched maternal plasma and umbilical cord plasma identified the above listed 3 microorganisms, all of which have previously been implicated in patients with chorioamnionitis (Mycoplasma hominis p = 0.0001; Ureaplasma parvum p = 0.002; Streptococcus mitis p = 0.007). These data show that the pathogen signal relevant for chorioamnionitis can be identified in both maternal and umbilical cord plasma. CONCLUSION This is the first report showing the detection of relevant microbial cell-free cfDNA in maternal plasma and umbilical cord plasma in patients with clinical and/or histological chorioamnionitis. These results may lead to the development of a specific assay to detect perinatal infections for targeted therapy to reduce early neonatal sepsis complications.
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Affiliation(s)
- Russell G. Witt
- Eli and Edythe Broad Center of Regeneration Medicine, University of California, San Francisco, California, United States of America
- Department of Surgery, University of California, San Francisco, California, United States of America
| | - Lily Blair
- Karius Inc., Redwood City, California, United States of America
| | - Michela Frascoli
- Eli and Edythe Broad Center of Regeneration Medicine, University of California, San Francisco, California, United States of America
- Department of Surgery, University of California, San Francisco, California, United States of America
| | - Michael J. Rosen
- Karius Inc., Redwood City, California, United States of America
- D2G Oncology, Inc: Mountain View, California, United States of America
| | - Quoc-Hung Nguyen
- Eli and Edythe Broad Center of Regeneration Medicine, University of California, San Francisco, California, United States of America
- Department of Surgery, University of California, San Francisco, California, United States of America
| | - Sivan Bercovici
- Karius Inc., Redwood City, California, United States of America
| | - Simona Zompi
- Karius Inc., Redwood City, California, United States of America
- Department of Experimental Medicine, School of Medicine, University of California, San Francisco, California, United States of America
| | - Roberto Romero
- Wayne State University, Detroit, Michigan, United States of America
- Perinatology Research Branch, National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan, United States of America
| | - Tippi C. Mackenzie
- Eli and Edythe Broad Center of Regeneration Medicine, University of California, San Francisco, California, United States of America
- Department of Surgery, University of California, San Francisco, California, United States of America
- Center for Maternal-Fetal Precision Medicine, University of California, San Francisco, California, United States of America
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Vinante V, Keller B, Huhn EA, Huang D, Lapaire O, Manegold-Brauer G. Impact of nationwide health insurance coverage for non-invasive prenatal testing. Int J Gynaecol Obstet 2018; 141:189-193. [PMID: 29215710 DOI: 10.1002/ijgo.12422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 10/05/2017] [Accepted: 12/06/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To describe the changes in women's choices for prenatal testing after the introduction of nationwide health insurance coverage for non-invasive prenatal testing (NIPT) in Switzerland. METHODS The present retrospective study reviewed data from all women with singleton pregnancies who presented at the prenatal unit of Basel University Hospital, Switzerland, for first-trimester screening between July 15, 2014, and December 31, 2015. Women were divided into three categories according to their risk for aneuploidy, and the uptake of NIPT in the period before and after the introduction of the nationwide coverage for NIPT was compared. RESULTS Overall, 887 women were included in the study: 573 screens were carried out before (group 1) and 314 after (group 2) the introduction of insurance coverage for NIPT. In group 1, 53 (9.2%) had NIPT as compared with 72 (22.9%) in group 2. Among women with intermediate risk for aneuploidies and basic insurance coverage, NIPT increased by 56% (12/88 [14%] vs 32/46 [70%]; P<0.001). CONCLUSION There was a notable increase in the uptake of NIPT; uptake was most significant among women with basic health insurance and intermediate risk for aneuploidy.
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Affiliation(s)
- Valentina Vinante
- Division of Prenatal and Gynecologic Ultrasound, Department of Obstetrics and Gynecology, Basel University Hospital, Basel, Switzerland
| | - Bettina Keller
- Division of Prenatal and Gynecologic Ultrasound, Department of Obstetrics and Gynecology, Basel University Hospital, Basel, Switzerland
| | - Evelyn A Huhn
- Division of Prenatal and Gynecologic Ultrasound, Department of Obstetrics and Gynecology, Basel University Hospital, Basel, Switzerland
| | - Dorothy Huang
- Division of Prenatal and Gynecologic Ultrasound, Department of Obstetrics and Gynecology, Basel University Hospital, Basel, Switzerland
| | - Olav Lapaire
- Division of Prenatal and Gynecologic Ultrasound, Department of Obstetrics and Gynecology, Basel University Hospital, Basel, Switzerland
| | - Gwendolin Manegold-Brauer
- Division of Prenatal and Gynecologic Ultrasound, Department of Obstetrics and Gynecology, Basel University Hospital, Basel, Switzerland
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Horn R, Parker M. Opening Pandora's box?: ethical issues in prenatal whole genome and exome sequencing. Prenat Diagn 2017; 38:20-25. [PMID: 28695688 PMCID: PMC5836985 DOI: 10.1002/pd.5114] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/03/2017] [Accepted: 07/06/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The development of genomic approaches to prenatal testing such as whole genome and exome sequencing offers the potential for a better understanding of prenatal structural anomalies in the fetus and ultimately for improved patient care and more informed reproductive decision making. In addition to the scientific and clinical challenges of achieving this, the introduction of new reproductive technologies also presents a number of ethical problems. The successful and appropriate development and introduction of prenatal genomics into clinical practice require these problems to be identified, understood and carefully analysed in the development of models of good ethical practice. METHOD We conducted a critical review of the existing literature on ethical issues in prenatal genomics. RESULTS We identified and discussed five areas of particular concern: valid consent, management and feed-back of information, responsibilities of health professionals, priority setting and resources and duties towards the future child. CONCLUSION There is a need for further discussion of the issues we have outlined here, and we hope that this brief summary of ethical arguments in the literature encourages researchers, clinicians, patients and scientists to engage in further discussion of these and other important issues raised by prenatal genomics. © 2017 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Ruth Horn
- The Ethox Centre, University of Oxford, Oxford, UK
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