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Expanding non‐invasive prenatal testing beyond chromosomes 21, 18, 13, X and Y
Author(s) -
Benn P.
Publication year - 2016
Publication title -
clinical genetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.543
H-Index - 102
eISSN - 1399-0004
pISSN - 0009-9163
DOI - 10.1111/cge.12818
Subject(s) - amniocentesis , genetic counseling , prenatal diagnosis , cell free fetal dna , trisomy , genetic testing , abnormality , population , advanced maternal age , chorionic villus sampling , karyotype , medicine , biology , genetics , obstetrics , chromosome , pregnancy , fetus , gene , environmental health , psychiatry
Non‐invasive prenatal testing ( NIPT ) based on cell‐free DNA in maternal plasma is being expanded to include additional chromosome abnormalities beyond those involving chromosomes 21, 18, 13, X and Y. Review of population cytogenetic data provides insight into the likely number of additional abnormalities detectable. Additional clinically significant and cytogenetically recognizable abnormalities are present in less than 0.1% of newborns but clinically significant, or potentially significant, sub‐microscopic imbalances are expected to be present in 1.7%. Cytogenetic studies on chorionic villus samples suggests that after excluding abnormalities involving chromosomes 21, 18, 13, X and Y, approximately 0.6% of NIPT results may be positive for an unbalanced abnormality attributable to mosaicism but most of these will not be confirmed at amniocentesis or in newborns. NIPT has also been developed for specific microdeletion syndromes and initial experience is now available. Laboratory procedures such as deeper sequencing and additional data analytics are rapidly evolving but even with existing protocols, it is already clear that NIPT does not necessarily need to be limited to trisomies 21, 18, 13 and the sex‐chromosome abnormalities. Patient educational materials and genetic counseling services need to be available for women offered expanded NIPT .