Abstract
An important factor in quality control of non-invasive prenatal screening (NIPS) or testing (NIPT) is a sufficient percentage of fetal DNA to avoid false-negative results. Here we evaluate 14,379 shallow whole-genome sequenced diagnostic NIPS samples, as well as negative controls, for both technical and biological factors that can influence fetal fraction and its assessment. Technically, bioinformatics analyses can have a profound impact on fetal fraction determination. We found best performance for fetal fraction determination with the Y chromosome based tool DEFRAG for male fetuses and the count based tool SeqFF for female fetuses. Biologically, gestational age of up to 21 weeks and maternal age had no influence on fetal fraction, while an increase in weight and BMI had a negative influence on fetal fraction. While a trend was observed, no statistically significant difference in fetal fraction was found between trisomy and normal samples. Overall, these results confirm the influence of biological factors and give insight into technical factors that can affect fetal fractions in NIPS.
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References
Takoudes T, Hamar B. Performance of non-invasive prenatal testing when fetal cell-free DNA is absent. Ultrasound Obstet Gynecol. 2015;45:112.
Wang Q, Cai Y, Brady P, Vermeesch JR. Real-time PCR evaluation of cell-free DNA subjected to various storage and shipping conditions. Genet Mol Res. 2015;14:12797–804.
Peng XL, Jiang P. Bioinformatics approaches for fetal DNA fraction estimation in noninvasive prenatal testing. Int J Mol Sci. 2017;18:E453.
van Beek DM, Straver R, Weiss MM, et al. Comparing methods for fetal fraction determination and quality control of NIPT samples. Prenat Diagn. 2017;37:769–73.
Song Y, Zhou X, Huang S, et al. Quantitation of fetal DNA fraction in maternal plasma using circulating single molecule amplification and re-sequencing technology (cSMART). Clin Chim Acta. 2016;456:151–6.
Hudecova I, Sahota D, Heung MM, et al. Maternal plasma fetal DNA fractions in pregnancies with low and high risks for fetal chromosomal aneuploidies. PLoS ONE. 2014;9:e88484.
Zhou Y, Zhu Z, Gao Y, et al. Effects of maternal and fetal characteristics on cell-free fetal DNA fraction in maternal plasma. Reprod Sci. 2015;22:1429–35.
Lee TJ, Rolnik DL, Menezes MA, McLennan AC, da Silva Costa F. Cell-free fetal DNA testing in singleton IVF conceptions. Hum Reprod. 2018;33:572–8.
Wang E, Batey A, Struble C, Musci T, Song K, Oliphant A. Gestational age and maternal weight effects on fetal cell-free DNA in maternal plasma. Prenat Diagn. 2013;33:662–6.
Ashoor G, Syngelaki A, Poon LC, Rezende JC, Nicolaides KH. Fetal fraction in maternal plasma cell-free DNA at 11-13 weeks’ gestation: relation to maternal and fetal characteristics. Ultrasound Obstet Gynecol. 2013;41:26–32.
Suzumori N, Ebara T, Yamada T, et al. Fetal cell-free DNA fraction in maternal plasma is affected by fetal trisomy. J Hum Genet. 2016;61:647–52.
Revello R, Sarno L, Ispas A, Akolekar R, Nicolaides KH. Screening for trisomies by cell-free DNA testing of maternal blood: consequences of a failed result. Ultrasound Obstet Gynecol. 2016;47:698–704.
Eiben B, Krapp M, Borth H, et al. Single nucleotide polymorphism-based analysis of cell-free fetal DNA in 3000 cases from Germany and Austria. Ultrasound Int Open. 2015;1:E8–E11.
van Schendel RV, Page-Christiaens GC, Beulen L, et al. Trial by Dutch laboratories for evaluation of non-invasive prenatal testing. Part II-women’s perspectives. Prenat Diagn. 2016;36:1091–8.
Oepkes D, Page-Christiaens GC, Bax CJ, et al. Trial by Dutch laboratories for evaluation of non-invasive prenatal testing. Part I-clinical impact. Prenat Diagn. 2016;36:1083–90.
Straver R, Sistermans EA, Holstege H, Visser A, Oudejans CB, Reinders MJ. WISECONDOR: detection of fetal aberrations from shallow sequencing maternal plasma based on a within-sample comparison scheme. Nucleic Acids Res. 2014;42:e31.
Straver R, Oudejans CB, Sistermans EA, Reinders MJ. Calculating the fetal fraction for noninvasive prenatal testing based on genome-wide nucleosome profiles. Prenat Diagn. 2016;36:614–21.
Kim SK, Hannum G, Geis J, et al. Determination of fetal DNA fraction from the plasma of pregnant women using sequence read counts. Prenat Diagn. 2015;35:810–5.
Friedman J, Hastie T, Tibshirani R. Regularization paths for generalized linear models via coordinate descent. J Stat Softw. 2010;33:1–22.
Izenman A. Reduced-rank regression for the multivariate linear model. J Multivar Anal. 1975;5:248–64.
Chan KC, Zhang J, Hui AB, et al. Size distributions of maternal and fetal DNA in maternal plasma. Clin Chem. 2004;50:88–92.
Acknowledgements
We are grateful to the VUmc NIPT team, the Dutch NIPT Consortium, and to all women who consented to participate in this study.
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Hestand, M.S., Bessem, M., van Rijn, P. et al. Fetal fraction evaluation in non-invasive prenatal screening (NIPS). Eur J Hum Genet 27, 198–202 (2019). https://doi.org/10.1038/s41431-018-0271-7
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DOI: https://doi.org/10.1038/s41431-018-0271-7
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