Association of Fetal Fraction of Cell-Free DNA and Hypertensive Disorders of Pregnancy

Whitney R. Bender; Nathanael C. Koelper; Mary D. Sammel; Lorraine Dugoff

doi:10.1055/s-0038-1667374

American Journal of Perinatology, Table of Contents

Am J Perinatol 2019; 36(03): 311-316
DOI: 10.1055/s-0038-1667374

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association of Fetal Fraction of Cell-Free DNA and Hypertensive Disorders of Pregnancy

Whitney R. Bender

¹Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

,

Nathanael C. Koelper

²Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

,

Mary D. Sammel

²Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

,

Lorraine Dugoff

¹Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

› Author Affiliations

Abstract

Objective The objective of this study is to examine the relationship between fetal fraction and hypertensive disorders of pregnancy.

Study Design This is a retrospective cohort study of women with singleton pregnancies who had cell-free DNA (cfDNA) screening at 10 to 20 weeks of gestation. The primary outcome was the development of gestational hypertension (gHTN), preeclampsia (PEC), and PEC with severe features. Multinomial logistic regression was performed to assess the relationship between fetal fraction and pregnancy outcomes of interest while controlling for potential confounders.

Results Among 2,701 women meeting inclusion criteria, 387 (14.3%) were diagnosed with hypertensive disorders of pregnancy. First-trimester fetal fraction was significantly lower in women diagnosed with hypertensive disorders of pregnancy (10.9 vs. 12.4, p < 0.0001). An increased risk of gHTN and PEC, PEC with severe features with delivery > 34 weeks, and PEC with severe features with delivery ≤ 34 weeks was seen with lower first-trimester fetal fractions (odds ratio [OR]: 0.55, 95% confidence interval [CI] [0.36–0.83], p = 0.005; OR: 0.59, 95% CI [0.35–0.99], p = 0.048; and OR: 0.27, 95% CI [0.08–0.96], p = 0.044). The relationship between fetal fraction and hypertensive disorders of pregnancy was not statistically significant after adjusting for maternal age, race, body mass index, and chronic hypertension.

Conclusion Fetal fraction of cfDNA at 10 to 20 weeks of gestation was not associated with the development of hypertensive disorders of pregnancy.

Keywords

cell-free DNA - fetal fraction - pregnancy - hypertension - preeclampsia

Full Text

References

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