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早期生长受限胎儿的基因组微阵列:一项多中心研究。

Genomic Microarray in Fetuses with Early Growth Restriction: A Multicenter Study.

作者信息

Borrell Antoni, Grande Maribel, Meler Eva, Sabrià Joan, Mazarico Edurne, Muñoz Anna, Rodriguez-Revenga Laia, Badenas Cèlia, Figueras Francesc

机构信息

BCNatal, Hospital Clínic de Barcelona, Barcelona, Spain.

出版信息

Fetal Diagn Ther. 2017;42(3):174-180. doi: 10.1159/000452217. Epub 2016 Nov 2.

Abstract

BACKGROUND

Little information is available about the risk of microdeletion and microduplication syndromes in fetal growth restriction (FGR) with a normal karyotype.

OBJECTIVE

To assess the incremental yield of genomic microarray over conventional karyotyping in fetuses with early growth restriction.

STUDY DESIGN

Genomic microarray was prospectively performed in fetuses with early growth restriction defined as a fetal weight below the 3rd percentile estimated before 32 weeks of pregnancy, and a normal quantitative fluorescent polymerase chain reaction result. The incremental yield of genomic microarray was defined by the rate of fetuses presenting with a pathogenic copy number variant below 10 Mb.

RESULTS

Among 133 fetuses with early FGR, a 6.8% (95% CI: 2.5-11.0) incremental yield of genomic microarray over karyotyping was observed. This incremental yield was 4.8% (95% CI: 0.2-9.3) in isolated FGR, 10% (95% CI: 0-20.7) in FGR with nonstructural anomalies, and 10.5% (95% CI: 0-24.3) in FGR with structural anomalies.

CONCLUSION

Our multicenter study reveals that 6.8% of fetuses with early growth restriction present with submicroscopic anomalies after common aneuploidies were excluded. Even when FGR is observed as an isolated finding, genomic microarray analysis should be considered after or instead of karyotyping, due to its 4.8% incremental yield.

摘要

背景

关于核型正常的胎儿生长受限(FGR)中微缺失和微重复综合征的风险,现有信息较少。

目的

评估基因组微阵列相对于传统核型分析在早期生长受限胎儿中的额外诊断率。

研究设计

对早期生长受限胎儿进行前瞻性基因组微阵列检测,这些胎儿定义为妊娠32周前估计胎儿体重低于第3百分位数且定量荧光聚合酶链反应结果正常。基因组微阵列的额外诊断率由检出小于10 Mb的致病性拷贝数变异的胎儿比例确定。

结果

在133例早期FGR胎儿中,观察到基因组微阵列相对于核型分析的额外诊断率为6.8%(95%可信区间:2.5 - 11.0)。在孤立性FGR中,该额外诊断率为4.8%(95%可信区间:0.2 - 9.3);在伴有非结构性异常的FGR中为10%(95%可信区间:0 - 20.7);在伴有结构性异常的FGR中为10.5%(95%可信区间:0 - 24.3)。

结论

我们的多中心研究表明,在排除常见非整倍体后,6.8%的早期生长受限胎儿存在亚显微异常。即使FGR是孤立发现,由于其4.8%的额外诊断率,在核型分析之后或可考虑采用基因组微阵列分析替代核型分析。

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