High platelet distribution width affects the detection of fetal fraction of cell-free DNA detected by non-invasive prenatal testing.

Abstract

Objective: The aim of this study was to investigate the effect of platelet distribution width (PDW) on fetal fraction (FF) of cell-free DNA (cfDNA) within non-invasive prenatal testing (NIPT) during pregnancy.

Methods: The study subjects were pregnant women who voluntarily underwent NIPT and had antenatal examinations at the Affiliated Suzhou Hospital of Nanjing Medical University from January 2016 to January 2021. They underwent routine blood tests before and after NIPT. Univariate and multivariate regression models were used to evaluate the correlation between complete blood count indices and FF.

Results: Multivariate linear regression analysis revealed that hemoglobin (Hb), white blood cell count (WBC), platelet count (PLT), red blood cell distribution width (RDW), PDW, and body mass index (BMI) were negatively correlated with FF, while the interval between the two tests was positively correlated with FF. Notably, PDW (standardized β: -0.097) was the second most significant factor after BMI (standardized β: -0.292). Further grouping by PDW showed that compared to PDW ≤ 12.0 fL, FF decreased by 0.070 (95% CI: -0.111 to -0.030; P = 0.001) and 0.191 (95% CI: -0.260 to -0.123; P < 0.001) in women with PDW levels of 12.1-15.0 fL and > 15.0 fL, respectively, showing a gradual decreasing trend (P_trend < 0.001).

Conclusion: Higher PDW values altered the FF detection, with an observed decrease in FF as PDW levels increased.