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基于单核苷酸多态性的胎儿DNA非侵入性产前检测非整倍体的临床应用:墨西哥的两年经验

[Clinical implementation of non-invasive prenatal study for detecting aneuploidies by fetal DNA based on single nucleotide polymorphisms: two years in Mexico].

作者信息

Sánchez-Usabiaga Rafael A, Aguinaga-Ríos Mónica, Batista-Espinoza Anaid, Hurtado-Amador Ricardo, Romero-Tovar Sergio

出版信息

Ginecol Obstet Mex. 2015 Apr;83(4):220-31.

PMID:26727755
Abstract

BACKGROUND

Recent data have shown that non invasive prenatal test (NIPT) for the detection of fetal aneuploidies (chromosomes 13, 18, 21, X, Y, and triploidy) by cell free fetal DNA in maternal blood (cfDNA) is a clinical reality, with detection rates > 99% and false positive rates of 0.1%. Results that exceed the first trimester screening.

OBJECTIVE

To describe our experience of 2 years integrating NIPT by cfADN in its variant of single nucleotide polymorphism (SNPs) as a screening method for the detection of common aneuploidies, since nine weeks of gestation.

PATIENTS AND METHODS

Observational prospective study from March 2013 to February 2015. Women with a singleton pregnancy were offered conventional prenatal screening fetal aneuploidy and or new alternative NIPT-SNPs.

RESULTS

270 women were included,the mean maternal age was 35.3 years with a mean gestational age of 11.85 weeks. The result was obtained in 98.5%, with an average report time of 7.5 working days. Blood collection was repeated in fifteen patients, obtaining the result in eleven. The NIPT tested positive for ten cases, 8 for trisomy 21, one for trisomy 18 and one trisomy 13.

CONCLUSIONS

We describe our first two years of integrating NIPT-SNPs to obstetric private practice, that is an alternative screening with the potential to be incorporated into theexisting algorithms in prenatal care, from the ninth week of gestation. We expect this information will motivate a debate on the issue of prenatal screening and get to improve obstetric care and genetic counseling in Mexico.

摘要

背景

最近的数据表明,通过母体血液中的游离胎儿DNA(cfDNA)检测胎儿非整倍体(染色体13、18、21、X、Y和三倍体)的无创产前检测(NIPT)已成为临床现实,其检测率>99%,假阳性率为0.1%。结果超过了孕早期筛查。

目的

描述我们在两年内将基于单核苷酸多态性(SNP)变体的cfADN进行NIPT作为检测常见非整倍体的筛查方法的经验,从妊娠9周开始。

患者和方法

2013年3月至2015年2月的观察性前瞻性研究。为单胎妊娠的妇女提供常规产前胎儿非整倍体筛查和/或新的替代NIPT-SNP。

结果

纳入270名妇女,平均产妇年龄为35.3岁,平均孕周为11.85周。98.5%的患者获得了结果,平均报告时间为7.5个工作日。15名患者重复采血,其中11名获得了结果。NIPT检测出10例阳性,21三体8例,18三体1例,13三体1例。

结论

我们描述了将NIPT-SNP整合到产科私人实践中的头两年经验,这是一种替代筛查方法,有可能从妊娠第9周起纳入现有的产前护理算法中。我们期望这些信息将引发关于产前筛查问题的辩论,并改善墨西哥的产科护理和遗传咨询。

相似文献

1
[Clinical implementation of non-invasive prenatal study for detecting aneuploidies by fetal DNA based on single nucleotide polymorphisms: two years in Mexico].基于单核苷酸多态性的胎儿DNA非侵入性产前检测非整倍体的临床应用:墨西哥的两年经验
Ginecol Obstet Mex. 2015 Apr;83(4):220-31.
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引用本文的文献

1
Genomics-based non-invasive prenatal testing for detection of fetal chromosomal aneuploidy in pregnant women.基于基因组学的非侵入性产前检测用于检测孕妇胎儿染色体非整倍体。
Cochrane Database Syst Rev. 2017 Nov 10;11(11):CD011767. doi: 10.1002/14651858.CD011767.pub2.