Low Fetal Fraction of Cell Free DNA at Non-Invasive Prenatal Screening Increases the Subsequent Risk of Preterm Birth in Uncomplicated Singleton Pregnancy.
Low Fetal Fraction of Cell Free DNA at Non-Invasive Prenatal Screening Increases the Subsequent Risk of Preterm Birth in Uncomplicated Singleton Pregnancy.
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DOI：
10.2147/ijwh.s364554
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发表时间：
2022
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探讨无创性产前筛查（NIPS）中无细胞DNA的低胎儿分数（FF）与无并发症单胎妊娠早产风险之间的关系。我们回顾性询问了2018年4月至2019年8月的NIPS系统和住院记录，并从1521名连续和无并发症的单胎妊娠妇女中获得了结果，其中NIPS的细胞游离DNA的血浆FF与出生结局一起进行了研究。我们通过回归分析研究了FF和早产（PTB）之间的关系。研究人群中早产、低出生体重和巨大儿的发生率分别为5.06%、2.89%和7.17%。FF在NIPS的第二至第一四分位数（分别为8.40 - 11.07、11.08 - 13.70和> 13.70%）与分娩时相对于最低四分位数的较高胎龄相关（<8.40%），估计平均增加0.27周（95% CI：0.05 - 0.49）、0.29周（95% CI：0.06 - 0.51）和0.28周（95% CI：0.05 - 0.51）（趋势P = 0.027）。与正常FF（≥第5和≤第95百分位数）相比，低FF（<第5百分位数）与PTB风险增加相关（校正OR：2.23，95% CI：1.01 - 4.98，P = 0.047）。此外，与NIPS时体重指数（BMI）<25且FF正常的妇女相比，低FF和BMI ≥ 25的妇女发生早期PTB（<34孕周）的风险显著升高（校正OR：6.29，95%CI：1.71 - 23.15，P = 0.006）。我们的研究支持无并发症单胎妊娠NIPS时低FF与PTB（尤其是早期PTB）的相关性。
To examine the association between low fetal fraction (FF) of cell free DNA determined at non-invasive prenatal screening (NIPS) and the subsequent risk of preterm birth in uncomplicated singleton pregnancy. We retrospectively interrogated NIPS System and hospitalization records from April 2018 to August 2019 and obtained results from 1521 consecutive and uncomplicated women with singleton pregnancy in which plasma FF of cell free DNA at NIPS had been investigated together with birth outcomes. We examined the association between FF and preterm birth (PTB) by regression analysis. The incidence of preterm birth, low birthweight, and macrosomia in the study population was 5.06%, 2.89%, and 7.17%, respectively. FF at NIPS in the second to fourth quartiles (8.40–11.07, 11.08–13.70, and >13.70%, respectively) was associated with higher gestational age at delivery relative to the lowest quartile (<8.40%), with estimated mean increases of 0.27 weeks (95% CI: 0.05–0.49), 0.29 weeks (95% CI: 0.06–0.51), and 0.28 weeks (95% CI: 0.05–0.51), respectively (P for trend = 0.027). Low FF (< the 5th percentile) was associated with an increased risk of PTB (adjusted OR: 2.23, 95% CI: 1.01–4.98, P = 0.047) compared to normal FF (≥ the 5th and ≤ the 95th percentiles). In addition, when compared to women with normal FF and body mass index (BMI) <25 at NIPS, the risk of early PTB (< 34 weeks gestation) was remarkably significantly higher among those with low FF and BMI ≥25 (adjusted OR: 6.29, 95% CI: 1.71–23.15, P = 0.006). Our study supports the association of low FF at NIPS with PTB (especially early PTB) for uncomplicated singleton pregnancy.