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dc.contributor.authorGaleva, Slavyana
dc.contributor.authorGil Mira, María del Mar 
dc.contributor.authorKonstantinidou, Liountmila
dc.contributor.authorAkolekar, Ranjit
dc.contributor.authorNicolaides, Kypros H.
dc.date.accessioned2019-07-17T10:02:26Z
dc.date.available2019-07-17T10:02:26Z
dc.date.issued2019
dc.identifier.issn0960-7692spa
dc.identifier.urihttp://hdl.handle.net/10641/1653
dc.description.abstractObjectives: To examine factors affecting the failure rate to obtain a result from (cf) DNA testing of maternal blood for fetal trisomies 21, 18 and 13 in singleton and twin pregnancies in the first trimester of pregnancy. Methods: This was a prospective study in 23,495 singleton and 928 twin pregnancies undergoing screening for fetal trisomies by targeted cfDNA testing at 10+0-14+1 weeks’ gestation. Multivariate regression analysis was used to determine significant predictors of failure to obtain a result after first sampling. Results: There was no result from cfDNA testing after first sampling in 3.4% (798/23,495) of singletons, 11.3% (91/806) of DC twins and in 4.9% (6/122) of MC twins. Multivariate logistic regression analysis demonstrated that the risk of test failure first, increased with increasing maternal age (odds ratio (OR) 1.02; 95% confidence interval (CI) 1.01, 1.04) and weight (OR 1.05; 95% CI 1.04, 1.05), decreasing gestational age (OR 0.85; 95% CI 0.79, 0.91) and serum PAPP-A (OR 0.56; 95% CI 0.49, 0.64) and free ß-hCG (OR 0.67; 95% CI 0.60, 0.74), second, was higher in women of Black (OR 1.72; 95% CI 1.33, 2.20) and South Asian (OR 1.99; 95% CI 1.56, 2.52) than White racial origin, in dichorionic twin (OR 1.75; 95% CI 1.34, 2.25) than singleton pregnancy and in in vitro fertilization (OR 3.82; 95% CI 3.19, 4.55) than natural conception and third, was lower in parous (OR 0.63; 95% CI 0.55, 0.74) than nulliparous women. Conclusions: Maternal age, weight, racial origin and parity, gestational age, dichorionicity, method of conception and serum levels of free ß-hCG and PAPP-A are independent predictors of cfDNA test failure. The risk of test failure is higher in dichorionic twin than in singleton pregnancies, mainly because a higher proportion of twins are conceived by in vitro fertilization and more of the women are nulliparous.spa
dc.language.isoengspa
dc.publisherUltrasound in Obstetrics and Gynecologyspa
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 España*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/es/*
dc.subjectCell-free DNAspa
dc.subjectFirst-trimester screeningspa
dc.subjectNon-invasive prenatal testingspa
dc.subjectTrisomy 21spa
dc.subjectTrisomy 18spa
dc.subjectTrisomy 13spa
dc.subjectTwin pregnancyspa
dc.subjectFetal fractionspa
dc.titleFirst-trimester screening for trisomies by cfDNA testing of maternal blood in singleton and twin pregnancies: factors affecting test failure.spa
dc.typearticlespa
dc.description.versionpre-printspa
dc.rights.accessRightsopenAccessspa
dc.description.extent429 KBspa
dc.identifier.doi10.1002/uog.20290spa


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