Lower Fetal Fraction in Clinical Cell-Free DNA (cfDNA) Screening Results is Associated with Increased Risk of Hypertensive Disorders of Pregnancy

Authors

Deeksha Madala
Mohamad Ali Maktabi
Riwa Sabbagh
Hadi Erfani
Andrea Moon
Ignatia B Van den Veyver

Publication Date

9-1-2022

Journal

Prenatal Diagnosis

DOI

10.1002/pd.6221

PMID

35943975

PMCID

PMC9655187

PubMedCentral® Posted Date

9-1-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Cell-Free Nucleic Acids, Female, Fetus, Humans, Hypertension, Pregnancy-Induced, Infant, Newborn, Pre-Eclampsia, Pregnancy, Retrospective Studies

Abstract

OBJECTIVE: To evaluate if fetal fraction (FF) reported on cell-free DNA (cfDNA) screening is a marker for adverse obstetric outcomes.

METHODS: We retrospectively reviewed medical records from a cohort of women with singleton pregnancies who had cfDNA screening. We evaluated if reported FF could predict the following pregnancy complications: hypertensive disorders of pregnancy (HDP), fetal growth restriction, preterm delivery, gestational diabetes mellitus, or a composite maternal morbidity, defined as the presence of at least one of these outcomes.

RESULTS: Receiver operating curve analysis was performed on FF from 534 women to define the FF that differentiated a low FF group (<10%; N=259) and a high FF group (≥ 10%; N=275). HDP were more common for women in the low FF group (32.0% vs. 11.6%, p<0.001), who had a two-fold odds of developing HDP (p=0.006). CMM was also more common for women in the low FF group (51.4% vs. 30.2%, p<0.001), who had a 1.7-fold odds of developing any of the adverse obstetrical outcomes (p=0.014).

CONCLUSION: We found that low FF on cfDNA screening is associated with an increased risk of HDP. Fetal fraction reported that cfDNA screening reports have potential as a predictive marker for the development of HDP and adverse outcomes.