Is there an optimal gestational age for cell-free DNA testing in maternal obesity?

Li, Zhen; Li, Dong-Zhi

doi:10.1016/j.ajog.2021.05.026

Cited by 1 publication

(1 citation statement)

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“…However, this new technology requires additional enrichment costs and has not been used in clinical practice. Moreover, other clinical studies have examined the effects of biological factors, including gestational age, BMI, triglyceride (TG), and alanine aminotransferase (ALT), on FF, with the aim of controlling these factors during pregnancy to decrease the maternal contribution and/or increase the placental contribution and to obtain higher fetal-derived cfDNA ( 7 – 10 ). These strategies are interesting and cost-effective.…”

Section: Introductionmentioning

confidence: 99%

White blood cell count affects fetal fraction and test failure rates in noninvasive prenatal screening

Qiao

Cao²,

Tang³

et al. 2023

Front. Med.

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ObjectiveTo investigate the effects of white blood cell (WBC) count on fetal fraction (FF), which is an essential quality control for obtaining reliable results, and on the rate of screen failures in noninvasive prenatal screening (NIPS).MethodsNoninvasive prenatal screening, serum lipid and liver enzyme level measurements, and WBC count were performed for 4,281 pregnancies with male fetuses. After adjusting for confounders, including the maternal characteristics and alanine aminotransferase (ALT) levels, the effect of WBC count on FF and test failure rate was measured by linear and logistic regression analyses.ResultsFetal fraction was negatively associated with BMI, ALT, IVF conceptions, and WBC count and positively correlated with gestational age in the multivariate linear regression model. Moreover, WBC count was the most important factor affecting FF after BMI according to the standardization coefficient analysis. In the 4,281 pregnancy samples with male fetuses, FF decreased with WBC count from 11.45% at ≤8 to 9.02% at >12, and FF markedly decreased to 7.40% in pregnancies with a higher WBC count (>12) and higher BMI (≥25 kg/m2). Meanwhile, the test failure rates were significantly higher in the WBC count > 12 group (4.29%) than in the WBC count ≤ 8 group (0.89%). Notably, when the BMI of pregnancies with a WBC count of >12 was >25, the rate reached 7.53%. Subsequently, multivariate logistic regression analysis further confirmed that an increased BMI and WBC count were independently and significantly associated with the test failure rates.ConclusionAn increased WBC count was associated with lower FF and higher test failure rates, suggesting that these important factors should be carefully considered during genetic counseling in pregnant women who decide to undergo blood collection or resampling.

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