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中国南方地区的无创性产前检测在双胎妊娠中的应用效能。

Performance of noninvasive prenatal testing for twin pregnancies in South China.

机构信息

Guangdong Women and Children Hospital, Guangzhou, 511442, Guangdong, China.

出版信息

J Assist Reprod Genet. 2023 Sep;40(9):2219-2231. doi: 10.1007/s10815-023-02881-1. Epub 2023 Jul 22.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the performance of noninvasive prenatal testing (NIPT) for the detection of chromosomal aneuploidies and copy number variations (CNVs) in twin pregnancies.

METHOD

A cohort of 2010 women with twin pregnancies was recruited. 1331 patients opted for NIPT, and 679 patients opted for expanded NIPT (NIPT-plus). All high-risk patients were advised to undergo invasive prenatal diagnosis. All participants were followed up until 6 months after birth.

RESULTS

Twenty-two cases were predicted to have a high risk of chromosome abnormalities by NIPT, of which 14 pregnant women underwent invasive prenatal diagnosis. The 14 cases included 3 cases of trisomy 21, 1 case of trisomy 18, 1 case of trisomy 7, 2 cases of sex chromosome aneuploidies (SCAs), and 7 cases of CNVs, of which the confirmed cases numbered 2, 1, 0, 1, and 0, respectively. Twenty cases were predicted to have a high risk of chromosome abnormalities by NIPT-plus, of which 16 pregnant women underwent invasive prenatal diagnosis. The 16 cases included 1 case of trisomy 21, 1 case of trisomy 7, 7 cases of SCAs, and 7 cases of CNVs, of which were confirmed in 1, 0, 3, and 2, respectively. No false-negative result was reported during the follow-up period.

CONCLUSION

The NIPT/NIPT-plus has excellent performance in the detection of chromosome aneuploidies in twin pregnancies. But for CNVs, the effectiveness of NIPT is poor, and the NIPT-plus have a certain detection efficiency. It is worth noting that pre- and post-genetic counseling is especially important, and the chorionicity, mode of conception, clinical indications, and fetal fraction should be considered as influencing factors.

摘要

目的

本研究旨在评估非侵入性产前检测(NIPT)在检测双胞胎妊娠中染色体非整倍体和拷贝数变异(CNVs)方面的性能。

方法

招募了 2010 名双胞胎孕妇。1331 名患者选择了 NIPT,679 名患者选择了扩展 NIPT(NIPT-plus)。所有高风险患者均被建议进行有创性产前诊断。所有参与者均随访至出生后 6 个月。

结果

NIPT 预测 22 例染色体异常高风险,其中 14 例孕妇接受了有创性产前诊断。14 例中包括 3 例 21 三体,1 例 18 三体,1 例 7 三体,2 例性染色体非整倍体,7 例 CNVs,其中确诊病例数分别为 2、1、0、1、0。NIPT-plus 预测 20 例染色体异常高风险,其中 16 例孕妇接受了有创性产前诊断。16 例中包括 1 例 21 三体,1 例 7 三体,7 例性染色体非整倍体,7 例 CNVs,其中确诊病例数分别为 1、0、3、2。随访期间无假阴性结果报告。

结论

NIPT/NIPT-plus 在检测双胞胎妊娠中的染色体非整倍体方面具有优异的性能。但对于 CNVs,NIPT 的有效性较差,NIPT-plus 具有一定的检测效率。值得注意的是,产前和产后遗传咨询特别重要,应考虑绒毛膜性、受孕方式、临床指征和胎儿分数等影响因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4fe/10440307/d5c8688a5f72/10815_2023_2881_Fig1_HTML.jpg

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