Diagnostic Value of Cell-Free DNA Fetal Fraction in Patients With Prenatally Suspected Placenta Accreta Spectrum Disorder.

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2025-08-01 Epub Date: 2025-07-19 DOI:10.1002/pd.6858

Danielle Chirumbole, Christian M Parobek, Alex Tai, Haleh Sangi-Haghpeykar, Yamely H Mendez, Spoorthi Kamepalli, Christina C Reed, Arthur Ladron de Guevara, Keneshia Lane, Claire Hoppenot, Amir A Shamshirsaz, Michael A Belfort, Jessian L Munoz, Hendrik A Lombaard

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Abstract

Objective: The purpose of this study was to investigate the relationship between fetal fraction (FF) and placenta accreta spectrum (PAS) pathology in patients with prenatally suspected PAS.

Methods: This was a case-control study utilizing a database of pregnancies with suspected or proven PAS delivered between 6/2012 and 7/2024 at a single institution. Pregnancies were excluded if FF was not reported. The primary outcome was mean FF in pregnancies with a final clinical diagnosis of low FIGO grade (no PAS or FIGO1-2) versus high FIGO grade (FIGO3) placenta accreta. Results were reported as mean FF ± standard error of the mean. Adjusted means were also reported after assessing confounders.

Results: Of the 468 pregnancies assessed, 128 met the full inclusion criteria. While the unadjusted mean FF in the low-grade group did not differ from the high-grade group (9.6% ± 0.49, n = 81 vs. 10.7% ± 0.64, n = 47; p = 0.22), the adjusted mean FF in the low-grade group was significantly lower than that in the high-grade group (9.3% ± 0.48 vs. 11.1% ± 0.64; p = 0.03).

Conclusions: While FF alone is unlikely to be clinically useful in predicting PAS pathology, NIPT results have the potential to improve the diagnostic precision of other clinical tools for PAS prediction.

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无细胞DNA胎儿分数对产前疑似胎盘增生谱系障碍的诊断价值。

目的：探讨产前疑似PAS患者胎儿分数（FF）与胎盘增生谱（PAS）病理的关系。方法：这是一项病例对照研究，利用一个单一机构在2012年6月至2024年7月期间分娩的疑似或证实PAS的孕妇数据库。如果未报告FF，则排除妊娠。主要结局是最终临床诊断为低FIGO级别（无PAS或FIGO1-2）与高FIGO级别（FIGO3）胎盘增生的妊娠的平均FF。结果报告为平均值FF±平均值的标准误差。在评估混杂因素后也报告了调整后的平均值。结果：在评估的468例妊娠中，128例符合全部纳入标准。而低分级组未经调整的平均FF与高分级组无差异(9.6%±0.49,n = 81 vs. 10.7%±0.64,n = 47；p = 0.22)，低分级组调整后平均FF显著低于高分级组(9.3%±0.48∶11.1%±0.64；p = 0.03)。结论：虽然FF在临床上不太可能用于预测PAS病理，但NIPT结果有可能提高其他临床工具对PAS预测的诊断精度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling