Noninvasive prenatal testing in Russia: a population study

Kudryavtseva E.V., Kanivets I.V., Kievskaya Yu.K., Baranov I.I., Kovalev V.V., Korostelev S.A.

1) Department of Obstetrics and Gynecology, Ural State Medical University, Ministry of Health of Russia, Yekaterinburg, Russia; 2) OOO “Genomed”, Moscow, Russia; 3) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia; 4) I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia
Objective. To evaluate the efficiency of DNA-based noninvasive prenatal test (NIPT) in identifying major aneuploidies in Russia.
Subjects and methods. The investigation enrolled 27,845 patients who had undergone NIPT in 2013–2018. The patients’ mean age was 34.2±3.63 years; the mean gestational age at which the women underwent NIPT was 15 weeks and 2 days’ gestation.
Results and discussion. Various NIPTs in Russia in 2013–2018 revealed a high risk of fetal chromosomal anomalies in 739 (2.6%) cases, 733 (99.18%) of them underwent invasive prenatal diagnosis, the presence of fetal chromosomal abnormalities was not confirmed in 12 (1.63%) cases. False negative results were 0.014%. The initial study could not yield a NIPT result in 1322 (4.7%) patients because of a low fetal fraction; however, the repeat study was effective in 80.1% of them.
Conclusion. NIPT is a more accurate study than standard combined prenatal screening and has high sensitivity and specificity for trisomies 13, 18, and 21.

Keywords

noninvasive prenatal DNA test
prenatal diagnosis
Down syndrome
prenatal screening

References

  1. Alysse M., Minear M.A., Berson E., Sridhar S., Rote M., Hung A. Non-invasive prenatal testing: a review of international implementation and challenges. Int J Womens Health. 2015; 7:113–26. doi: 10.2147/IJWH.S67124
  2. Неинвазивный пренатальный ДНК-скрининг анеуплоидий плода по крови матери методом высокопроизводительного секвенирования. Клинические рекомендации. Акушерство и гинекология. 2016; 6. [Non-invasive prenatal DNA-screening of fetal aneuploidy by maternal blood using high throughput sequencing (Clinical guidelines). Akusherstvo I ginekologia. 2016; 6 (in Russian)]. doi:10.18565/aig.2016.6.recomendations
  3. Norton M.E., Jacobsson B., Swamy G.K., Laurent L.C., Ranzini A.C., Brar H.,et al. Cell-free DNA analysis for noninvasive examination of trisomy. N. Engl. J. Med. 2015; 372(17): 1589–97. doi: 10.1056/NEJMoa1407349
  4. Nikolaides K.N., Syngelaki A., Gil M., Atanasova V., Markova D. Validation of targeted sequencing of single-nucleotide polymorphisms for non-invasive prenatal detection of aneu- ploidy of chromosomes 13, 18, 21, X, and Y. Prenat Diagn. 2013; 33: 575–9. doi: 10.1002/pd.4103
  5. Nicolaides K. H., Syngelaki A., Ashoor G., Birdir C., Touzet G. Noninvasive prenatal testing for fetal trisomies in a routinely screened first-trimester population. Am J Obstet Gynecol. 2012; 207: 374: e1–6. doi: 10.1016/j.ajog.2012.08.033
  6. Cell-free DNA screening for fetal aneuploidy. ACOG commetee opinion. N640, 2015. doi: 10.1097/AOG.0000000000001051.
  7. Баранова Е.Е., Беленикин М.С., Жученко Л.А., Ижевская В.Л. Неинвазивные пренатальные тесты: европейские и американские рекомендации по применению в клинической практике. Медицинская генетика. 2017; 16(8): 3–10. [Baranova E.E., Belenikin M.S., Zhuchenko L.A., Izhevskaya V.L. Non-invasive prenatal tests: european and american recomendations. Medicinskaya Genetica. 2017; 16(8): 3–10. (In Russian)].
  8. Pos O., Budis J., Szemes T. Recent trends in prenatal genetic screening and testing. F1000Res. 2019; 8: pii: F1000 Faculty Rev-764. doi: 10.12688/f1000research.16837.1.
  9. Prefumo F., Paolini D., Speranza G., Palmisano M., Dionisi M., Camurri L. The contingent use of cell-free fetal DNA for prenatal screening of trisomies 21, 18, 13 in pregnant women within a national health service: A budget impact analysis. PLoS One. 2019; 14(6): e0218166. doi: 10.1371/journal.pone.0218166
  10. Трофимов Д.Ю. Вопросы правового регулирования в области репродуктивной генетики. В кн.: Мохов А.А., Сушкова О.В., ред. Право и современные технологии в медицине. М.: РГ-Пресс, 2019: 89–90.[Trofimov D.Yu. Issues of legal regulation in the field of reproductive genetics. In the book: A.А. Mokhov, O.V. Sushkova, ed. Law and modern technology in medicine. M .: RG-Press, 2019: 89–90.(in Russian)].
  11. Анализ результатов раннего пренатального скрининга в Российской Федерации АУДИТ-2018. Информационно-справочные материалы. Москва, 2018. [Analysis of the results of early prenatal screening in the Russian Federation AUDIT-2018. Information and reference materials. Moscow, 2018(in Russian)].
  12. Lee D.E., Kim H., Park J., YunT., Park D.Y., Kim M., et al. Clinical Validation of Non-Invasive Prenatal Testing for Fetal Common Aneuploidies in 1,055 Korean Pregnant Women: a Single Center Experience. J Korean Med Sci. 2019; 34(24): e172. doi: 10.3346/jkms.2019.34.e172
  13. Кудрявцева Е.В., Ковалев В.В., Канивец И.В., Киевская Ю.К., Коростелев С.А. Free-DNA плода: опыт популяционного скрининга хромосомной патологии в России. Вопросы гинекологии, акушерства и перинатологии. 2019; 18(30): 46–51. [Kudryavtseva E.V., Kovalev V.V., Kanivets I.V., Kievskaya J.K., Korostelev S.A. Free-DNA of the fetus: the experience of population screening of chromosomal pathology in Russia. Voprosi ginekologii, akusherstva I perinatologii. 2019; 18(30): 46–51]. doi: 10.20953/1726-1678-2019-3-46-51
  14. ACMG 2016 Update on Noninvasive Prenatal Testing for Fetal Aneuploidy: Implications for India. J. fetal. med. 2017: 4(1): 1–6. doi: 10.1007/s40556-017-0116-4
  15. Шубина Е.С., Барков И.Ю., Ступко О.К., Кузнецова М.В., Крашенинникова Р.В., Ким Л.В., Тетруашвили Н.К., Гольцов А.Ю., Кочеткова Т.О., Мукосей И.С., Каретникова Н.А., Бахарев В.А., Трофимов  Д.Ю. Мозаицизм плода как причина ложноотрицательного результата неинвазивного пренатального ДНК-скрининга анеуплоидий по 21-й хромосоме. Акушерство и гинекология. 2018; 11: 31–34. [Shubina E.S., Barkov I.U., Stupko O.K., Kuznetsova M.V., Krasheninnikova R.V.,Kim L.V., Tetruashvili N.K., Goltsov A.Yu., Kochetkova T.O., Mukosey I.S., Karetnikova N.A., Bakharev V.A., Trofimov D.Yu. Fetal mosaicism as a cause of false-negative noninvasive prenatal DNA screening for chromosome 21 aneuploidies. Akusherstvo i ginekologia/Obstetrics and Gynecology. 2018; 11: 31–34 (in Russian)]. doi: 10.18565/aig.2018.11.31-34.
  16. Ying X., Guodong Z., Hong L., Qin Z., Jiafeng L., Bin Y., et al. Non- invasive prenatal testing to detect chromosome aneuploidies in 57,204 pregnancies. Mol Cytogenet. 2019; 12: 29. Doi: 10.1186/s13039-019-0441-5
  17. Karge A., Graupner O., Abel K., Kuschel B. Maternal Tumor Disease as a Reason for Repeated Test Failure in Cell-Free DNA Screening. Z Geburtshilfe Neonatol. 2019; 223(3): 179–83. doi: 10.1055/a-0850-0650.
  18. Palomaki G. E., Kloza E.M., O’Brien B.M., Eklund E.E., Lambert-Messerlian G.M. The clinical utility of DNA-based screening for fetal aneuploidy by primary obstetrical care providers in the general pregnancy popularion. Genetics in Medicine. 2017; 19(7): 778–86. doi: 10.1038/gim.2016.194.
  19. Qiao L., Zhang Q., Liang Y.,, Gao A., Ding Y., Zhao N., et al. Sequencing of short cfDNA fragments in NIPT improves fetal fraction with higher maternal BMI and early gestational age. Am J Transl Res. 2019; 11(7): 4450–9.PMC6684886.

Received 01.11.2019

Accepted 29.11.2019

About the Authors

Elena V. Kudryavtseva, PhD, associate professor of the Department of Obstetrics and Gynecology FPK and PP and PF FSBEI HE UMMU. Tel .: +7(922)616-4012;
e-mail: elenavladpopova@yandex.ru; https://orcid.org/0000-0003-2797-1926
620109 Russia, Yekaterinburg, Repin, d. 3.
Ilya V. Kanivets, PhD, head of the department of genetics. LLC “Genomed”. Tel .: +7 (495)660-83-77; e-mail: dr.kanivets@genomed.ru;
https://orcid.org/0000-0001-5821-9783 115093 Russia, Moscow, Podolskoye Shosse, 8, building. 5.
Julia K. Kievskaya, geneticist of LLC Genomed. Tel.: +7 (495)660-83-77; e-mail: jk@genomed.ru
115093, Russia, Moscow, Podolskoye Shosse, 8, bldg. 5.
Igor I. Baranov, MD, professor, head of the organizational and methodological department of FSBI NIMITs AGiP them. Kulakova, Moscow. Tel .: +7(495)438-94-92.
E-mail: i_baranov@oparina4.ru Address: 117997, Russia, Moscow Academician Oparin, d. 4.
Vladislav V. Kovalev, MD, professor, head of the Department of Obstetrics and Gynecology, FPK and PP and PF FSBEI HE UMMU. Tel .: +7(919)360-0670;
e-mail: vvkovalev55@gmail.com 620109, Russia, Yekaterinburg, Repin, 3.
Sergey A. Korostelev, MD, professor of the Department of Organization and Management in the Field of Drug Circulation, Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after THEM. Sechenov of the Ministry of Health of Russia. Phone: +7 (499) 609-14-00;
e-mail: korostelevsa@sesana.ru; http://orcid.org/0000-0002-3816-8031
119991 Russia, Moscow, ul. Bolshaya Pirogovskaya, d. 2, p. 4.

For citation: Kudryavtseva E.V., Kanivets I.V., Kievskaya J.K., Baranov I.I., Kovalev V.V., Korostelev S.A. Non-invasive prenatal test in Russia: a population study.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2019; 12:30-5. (In Russian).
https://dx.doi.org/10.18565/aig.2019.12.30-35

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.