Hierarchical Classification of Factors Associated With Noninvasive Prenatal Testing Failures and Its Impact on Pregnancy Outcomes  

作　　者：Jieqiong Xie Yu Jiang Yulin Zhou Dandan Jin Xingxiu Lu Yunsheng Ge 

机构地区：[1]Department of Prenatal Diagnosis Center,Women and Children's Hospital,School of Medicine,Xiamen University,Xiamen,Fujian 361001,China [2]United Diagnostic and Research Center for Clinical Genetics,Women and Children's Hospital,School of Medicine and School of Public Health,Xiamen University,Xiamen,Fujian 361001,China

出　　处：《Maternal-Fetal Medicine》2024年第4期215-224,共10页母胎医学杂志（英文）

基　　金：funded by the Key Project on Science and Technology Program of Fujian Health Commission(No.2021ZD01002);the Natural Science Foundation of Xiamen,China(Grant No.3502Z20227299);the General Science and Technology Project of Xiamen,China(Grant No.3502Z20224014);the Medical Innovation Project of Fujian Province(Grant No.2021CXB025).

摘　　要：Objective: To conduct a hierarchical classification analysis of the nonreportable results of noninvasive prenatal testing in an attempt to reduce failure rates and provide pregnant women with accurate information to alleviate their anxiety.Methods: In this study,30,039 singleton pregnancies who underwent noninvasive prenatal testing in a single center from May 2019 to April 2022 were collected,and 811 samples with initial noninvasive prenatal testing failure were retrospectively analyzed.Grouping was based on the reasons for initial test failure;tracking the noninvasive prenatal testing results and prenatal diagnosis results(if any)of the“z-scores in the gray area”group and analyzing the possible influencing factors of the“low fetal fraction”group in the pre-experimental and experimental period by using one-way analysis of variance,Mann-Whitney U test,and χ^(2) test;and tracking the pregnancy outcomes of the test failures samples to analyze the risk of perinatal complications and adverse pregnancy outcomes of the different types of test failures.Results: None of the samples'initial inconclusive results because of z-scores in the gray area were found to have chromosomal aneuploidy.However,pregnancy complications(P=0.018)and a high likelihood of adverse pregnancy outcomes(P=0.048)may still occur.Maternal gestational age(P<0.001),body mass index(P<0.001),library concentration(P<0.001),and fetal gender(P<0.001)were considered to be the associated factors for the initial low fetal fraction results.This may be associated with pregnancy complications(P<0.001)and a high likelihood of adverse pregnancy outcomes(P=0.034).The body mass index(P=0.015)and time between draws(P=0.001)were associated with the second test’s success.The incidence of low fetal fraction samples was more frequent with blood collection tubes of the G type than with the K type(P<0.001).Conclusion: Initial inconclusive results because of z-scores in the gray area did not imply an increased risk of aneuploidy,but vigilance is needed for an inc

关 键 词：Noninvasive prenatal testing Initial failure rate Low fetal fraction Positive predictive values Z-SCORE 

分 类 号：R714[医药卫生—妇产科学]