Public Health Genetics, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
Prenat Diagn. 2018 Nov;38(12):904-910. doi: 10.1002/pd.5352. Epub 2018 Sep 24.
To examine the statewide utilisation of prenatal diagnosis (PNDx) and preimplantation genetic diagnosis (PGT-M) for single gene disorders.
Population-based study of all women utilising PNDx in the Australian state of Victoria from 1977 to 2016. Single gene disorders were categorised using a systematic approach that aimed to reflect aspects of the PNDx decision-making process. Data on PGT-M for single gene disorders from 2005 to 2016 were similarly examined for comparison. Statistical significance testing was performed with χ test.
Following an initial uptake period, annual PNDx rates for single gene disorders stabilised between 1.3 and 2.2 per 1000 births after the year 2000. The majority of PNDx (72%) was performed for disorders that primarily impair physical ability, while PNDx for adult onset conditions was rare (3%). PGT-M for single gene disorders has seen rapid growth since its introduction, and annual numbers now equal that of PNDx. In contrast to PNDx, one quarter of PGT-M tests were performed for adult onset conditions.
Our population-wide analysis has demonstrated a steady demand for PNDx for single gene disorders over the past decade, in contrast to the rapidly increasing utilisation of PGT-M. PGT-M appears to be the preferred testing modality for adult onset disorders.
研究单基因疾病在澳大利亚维多利亚州的产前诊断(PNDx)和植入前遗传学诊断(PGT-M)的全州利用情况。
对 1977 年至 2016 年期间澳大利亚维多利亚州所有利用 PNDx 的女性进行基于人群的研究。采用系统的方法对单基因疾病进行分类,旨在反映 PNDx 决策过程的各个方面。同样对 2005 年至 2016 年期间单基因疾病的 PGT-M 数据进行了比较分析。采用 χ 检验进行统计学显著性检验。
在初始采用期之后,2000 年以后,单基因疾病的年度 PNDx 率稳定在每 1000 例活产 1.3 至 2.2 例之间。大多数 PNDx(72%)是针对主要损害身体能力的疾病进行的,而针对成人发病疾病的 PNDx 则很少见(3%)。PGT-M 自引入以来呈快速增长趋势,年检测数量现已与 PNDx 相当。与 PNDx 不同,四分之一的 PGT-M 检测是针对成人发病疾病进行的。
我们的全人群分析表明,过去十年中,单基因疾病的 PNDx 需求稳定,而 PGT-M 的利用率迅速增加。PGT-M 似乎是成人发病疾病的首选检测方式。