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Clinical experience and follow-up with large scale single-nucleotide polymorphism–based noninvasive prenatal aneuploidy testing

Open access
Dar, Pe'er, Curnow, Kirsten J., Gross, Susan J., Hall, Megan P., Stosic, Melissa, Demko, Zachary, Zimmermann, Bernhard, Hill, Matthew, Sigurjonsson, Styrmir, Ryan, Allison, Banjevic, Milena, Kolacki, Paula L., Koch, Susan W., Strom, Charles M., Rabinowitz, Matthew, Benn, Peter·2014·American Journal of Obstetrics and Gynecology

Abstract

OBJECTIVE: We sought to report on laboratory and clinical experience following 6 months of clinical implementation of a single-nucleotide polymorphism-based noninvasive prenatal aneuploidy test in high- and low-risk women. STUDY DESIGN: All samples received from March through September 2013 and drawn ≥9 weeks' gestation were included. Samples that passed quality control were analyzed for trisomy 21, trisomy 18, trisomy 13, and monosomy X. Results were reported as high or low risk for fetal aneuploidy for each interrogated chromosome. Relationships between fetal fraction and gestational age and maternal weight were analyzed. Follow-up on outcome was sought for a subset of high-risk cases. False-negative results were reported voluntarily by providers. Positive predictive value (PPV) was calculated from cases with an available prenatal or postnatal karyotype or clinical evaluation at birth. RESULTS: Samples were received from 31,030 patients, 30,705 met study criteria, and 28,739 passed quality-control metrics and received a report detailing aneuploidy risk. Fetal fraction correlated positively with gestational age, and negatively with maternal weight. In all, 507 patients received a high-risk result for any of the 4 tested conditions (324 trisomy 21, 82 trisomy 18, 41 trisomy 13, 61 monosomy X; including 1 double aneuploidy case). Within the 17,885 cases included in follow-up analysis, 356 were high risk, and outcome information revealed 184 (51.7%) true positives, 38 (10.7%) false positives, 19 (5.3%) with ultrasound findings suggestive of aneuploidy, 36 (10.1%) spontaneous abortions without karyotype confirmation, 22 (6.2%) terminations without karyotype confirmation, and 57 (16.0%) lost to follow-up. This yielded an 82.9% PPV for all aneuploidies, and a 90.9% PPV for trisomy 21. The overall PPV for women aged ≥35 years was similar to the PPV for women aged <35 years. Two patients were reported as false negatives. CONCLUSION: The data from this large-scale report on clinical application of a commercially available noninvasive prenatal test suggest that the clinical performance of this single-nucleotide polymorphism-based noninvasive prenatal test in a mixed high- and low-risk population is consistent with performance in validation studies.

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Metadata

Authors
Dar, P., Curnow, K. J., Gross, S. J., Hall, M. P., Stosic, M., Demko, Z., Zimmermann, B., Hill, M., Sigurjonsson, S., Ryan, A., Banjevic, M., Kolacki, P. L., Koch, S. W., Strom, C. M., Rabinowitz, M., & Benn, P.
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2014-11
Volume
211
Issue
5
Pages
527.e1-527.e17
ISSN
0002-9378 (ISSN-L)
OpenAlex
W2069401773
Cited by
277
References
36
FWCI
34.40
Type
journal article
Language
en
Open access
hybrid

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Dar, P., Curnow, K. J., Gross, S. J., Hall, M. P., Stosic, M., Demko, Z., Zimmermann, B., Hill, M., Sigurjonsson, S., Ryan, A., Banjevic, M., Kolacki, P. L., Koch, S. W., Strom, C. M., Rabinowitz, M., & Benn, P. (2014). Clinical experience and follow-up with large scale single-nucleotide polymorphism–based noninvasive prenatal aneuploidy testing. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2014.08.006

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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