MicroRNAs in Fetal Umbilical Cord Blood as a Prenatal Screening Tool for Congenital Heart Disease

Objective. MicroRNAs (miRNAs) have been used as molecular markers for various diseases. This study aimed to evaluate the predicted performance of miRNAs in fetal umbilical cord blood for detecting congenital heart disease (CHD). Methods. In this retrospective cohort study, a total of 60 pregnant women (involving 30 fetuses with CHD and 30 normal fetuses requiring induction of labor) were included. Umbilical cord blood was collected for miRNA measurement. Expression levels of the miRNAs were detected by qRT-PCR. The predictive accuracy of miRNA was assessed by constructing a receiver operating characteristic (ROC) curve and evaluated by calculating the area under the curve (AUC). The point biserial correlation coefficient (PBCC) was analyzed to evaluate the correlation of miRNA with CHD. Results. The CHD group and control group were well-balanced in age, gravidity, and parity. miRNA-133 was not detected in all subjects. Subjects with CHD fetuses had significantly lower levels of miRNA-1, miRNA-208, and miRNA-499. Different types of CHD showed different variation trends of miRNA expression. Correlation analysis showed that expression levels of miRNA-1, miRNA-208, and miRNA-499 were negatively correlated with the occurrence of CHD, with a PBCC of -0.65, -0.47, and -0.60, respectively. miRNA-1, miRNA-208, and miRNA-499 displayed an AUC of 0.86 (95% CI, 0.76-0.96; p<0.001), 0.75 (95% CI, 0.63-0.87; p=0.009), and 0.84 (95% CI, 0.74-0.95; p<0.001), respectively, for discriminating CHD from normal fetuses, with cut-off values of 0.795, 0.835, and 0.795, respectively. Conclusion. The expression levels of miRNA-1, miRNA-208, and miRNA-499 in umbilical cord blood may be useful for predicting fetal CHD. The findings indicated that miRNAs have the potential to be a prenatal screening tool in the early diagnosis of CHD.