Uptake of non-invasive prenatal testing (NIPT) and impact on invasive procedures in a tertiary referral center

被引:17
作者
Manegold-Brauer, Gwendolin [1 ,2 ]
Berg, C. [1 ,3 ]
Floeck, A. [1 ]
Rueland, A. [1 ]
Gembruch, U. [1 ]
Geipel, A. [1 ]
机构
[1] Univ Med Sch Bonn, Dept Obstet & Prenatal Med, D-53105 Bonn, Germany
[2] Univ Med Sch Basel, Dept Prenatal Med & Gynecol Ultrasound, Basel, Switzerland
[3] Univ Med Sch Cologne, Dept Obstet & Gynecol, Div Prenatal Med & Gynecol Ultrasound, Cologne, Germany
关键词
NIPT; NIPD; Cell-free fetal DNA; Fetal aneuploidies; Prenatal counseling; Non-invasive prenatal testing; Trisomy; 21; CELL-FREE DNA; FETAL DNA; ANEUPLOIDY; TRISOMY-21; DIAGNOSIS; WOMEN; POSITION; SOCIETY; RATES; CARE;
D O I
10.1007/s00404-015-3674-5
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
The introduction of non-invasive prenatal testing (NIPT) by isolation of cell-free fetal DNA from maternal blood is a new diagnostic option in prenatal care. The aim of the study was to investigate the algorithm of prenatal testing before and after the introduction of NIPT in a tertiary referral center and to investigate the influence of NIPT on the frequency of invasive procedures. Retrospective data analysis was conducted of all singleton pregnancies that presented for first trimester screening 17 months before and after the introduction of NIPT (n = 2271). Women were categorized into three risk groups: low risk for trisomy 21 (< 1:1000), intermediate risk (1:101-1:1000) and high risk (a parts per thousand yen1:100). The choice of diagnostic testing after FTS was analyzed. 1093 (group 1) presented before and 1178 (group 2) after the introduction of NIPT. The rate of high-risk patients was equal in both groups (14.4 vs. 15.4 %). No differences were found with regard to invasive testing (11.6 vs. 11.3 %). NIPT was chosen by 3.7 % (44/1178) in group 2. Of those with NIPT, 72.7 % had a risk estimate of < 1:100, but 90.9 % were a parts per thousand yen35 years old. The rate of NIPT among high-risk patients with a normal ultrasound examination was 25 %. At present, NIPT is chosen mainly for reassurance by patients not considered to be at high risk. In the high-risk group, NIPT can be offered if the ultrasound examination is normal and the risk is high due to maternal age or serum screening alone. The rate of invasive testing was not reduced in this selected population.
引用
收藏
页码:543 / 548
页数:6
相关论文
共 36 条
[11]   Noninvasive detection of fetal trisomy 21 by sequencing of DNA in maternal blood: a study in a clinical setting [J].
Ehrich, Mathias ;
Deciu, Cosmin ;
Zwiefelhofer, Tricia ;
Tynan, John A. ;
Cagasan, Lesley ;
Tim, Roger ;
Lu, Vivian ;
McCullough, Ron ;
McCarthy, Erin ;
Nygren, Anders O. H. ;
Dean, Jarrod ;
Tang, Lin ;
Hutchison, Don ;
Lu, Tim ;
Wang, Huiquan ;
Angkachatchai, Vach ;
Oeth, Paul ;
Cantor, Charles R. ;
Bombard, Allan ;
van den Boom, Dirk .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2011, 204 (03)
[12]  
Ekelund CK, 2008, BMJ-BRIT MED J, V337, DOI 10.1136/bmj.a2547
[13]   The Impact of Noninvasive Prenatal Testing on the Practice of Maternal-Fetal Medicine [J].
Friel, Lara A. ;
Czerwinski, Jennifer L. ;
Singletary, Claire N. .
AMERICAN JOURNAL OF PERINATOLOGY, 2014, 31 (09) :759-763
[14]   Changing attitudes towards non-invasive aneuploidy screening at advanced maternal age in a German tertiary care center [J].
Geipel, A. ;
Daiss, T. ;
Katalinic, A. ;
Germer, U. ;
Kohl, T. ;
Krapp, M. ;
Gembruch, U. ;
Berg, C. .
ULTRASCHALL IN DER MEDIZIN, 2007, 28 (01) :67-70
[15]   Analysis of Cell-Free DNA in Maternal Blood in Screening for Aneuploidies: Meta-Analysis [J].
Gil, M. M. ;
Akolekar, R. ;
Quezada, M. S. ;
Bregant, B. ;
Nicolaides, K. H. .
FETAL DIAGNOSIS AND THERAPY, 2014, 35 (03) :156-173
[16]   Implementation of maternal blood cell-free DNA testing in early screening for aneuploidies [J].
Gil, M. M. ;
Quezada, M. S. ;
Bregant, B. ;
Ferraro, M. ;
Nicolaides, K. H. .
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 2013, 42 (01) :34-40
[17]   A robust second-generation genome-wide test for fetal aneuploidy based on shotgun sequencing cell-free DNA in maternal blood [J].
Guex, N. ;
Iseli, C. ;
Syngelaki, A. ;
Deluen, C. ;
Pescia, G. ;
Nicolaides, K. H. ;
Xenarios, I. ;
Conrad, B. .
PRENATAL DIAGNOSIS, 2013, 33 (07) :707-710
[18]   REDUCING THE NEED FOR AMNIOCENTESIS IN WOMEN 35 YEARS OF AGE OR OLDER WITH SERUM MARKERS FOR SCREENING [J].
HADDOW, JE ;
PALOMAKI, GE ;
KNIGHT, GJ ;
CUNNINGHAM, GC ;
LUSTIG, LS ;
BOYD, PA .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 330 (16) :1114-1118
[19]   The Impact of First Trimester Screening and Early Fetal Anomaly Scan on Invasive Testing Rates in Women with Advanced Maternal Age [J].
Hagen, A. ;
Entezami, M. ;
Gasiorek-Wiens, A. ;
Albig, M. ;
Becker, R. ;
Knoll, U. ;
Stumm, M. ;
Wegner, R. -D. .
ULTRASCHALL IN DER MEDIZIN, 2011, 32 (03) :302-306
[20]   First-trimester screening for trisomy 21 by free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A: impact of maternal and pregnancy characteristics [J].
Kagan, K. O. ;
Wright, D. ;
Spencer, K. ;
Molina, F. S. ;
Nicolaides, K. H. .
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 2008, 31 (05) :493-502