Non-Invasive Prenatal Testing (NIPT) Faetsheet AntiCipate future directions 01 the technology Critically evaluate NIPT tests and laboralories Counsel women about their screening/testing options anj lOterpret and counsel ab:>ut results WHAT THIS RESOURCE CAN HELP YOU ACCOMPLISH: This resource is designed to help you: Apply NIPT appropriate. ly in the general prenatal screening/testing paradigm for trisomy 21 All laboratories offering NIPT report on trisomy 21 and triso- my 18. Others may also provide information aboJt trisomy 13, or some sex chromosome abnJr- malities. NIPT does not typically provide any other genetic infor- mation about tha genetic consti- tution of the mother or fetus Detection rate for trisomy 21 Al least 99% ct all preg- nancies with trisomy 21 can be detected using this test. However, up to 1 in 100 pre~- nancies with trisomy 21 will have a normal result and be missed on screening. He false-posi:ive rate is approximately 0.2%, mean. ing 1 in about SOD unaffecte::t pregnancies are reported as 'positive' or 'consistent with' trisomy' 21. For that reason, it is recommended that CVS or amniocentesis be consid. ered after an abnormal result to confirm the presence of a chromosome abnormality .• Detection rate for trisomy 18 He detection rate for trisomy 18 may be similar to that for trisomy 21; approximately 99% 01 plegnancies with trisomy 18 will be detected by NIPT. About 1 in 100 pregnancies with trisomy 18 will be missed on screening. He false-posi:ive rate is also similar to trisomy 21. About 1 in 500 preg- nancies unaffected with trisomy 18 will have an abnormal, or positive, result, so confirmatory testirg is recommended." Detection of trisomy 13 and sex chromosome abnonnalities H,ere is less confidence ir NIPT as a screen for trisomy 13 due to technical issues and the infrequency of the condition. Detection rates between 79-92% have been reported, meaning between 8 to 21 out of 100 pregnancies with affected fetuses •••• ill be missed. The false-positive rate may be about 1%. so 1 out of 100 unaffected pregnancies may be positive lor trisomy 13, so confirmatory testing is recommended.' Some laboratories may report results for sex chromosomes abnormal. ities. If testing for sex chrorT()some abnormalities is desired, contact the NIPT laboratory "(Actual numters will vary Check wirh the specific laboratory) !,,,bbJiwJI<IJ :.m12 ",wiiiiM 8 ';".I:'M 1011 ONCHrr:G. NS(;C AII ••gI", mHtJt'ti -_ .. ~ Genetic Il!OI Counselors f::!- created by WS:t?:~ & Introduction NIPT, which analyzes cell-free letal DNA circulating in maternal blood, is a new option in the prena:al screening and testing paradigm for trisomy 21 and a few other fetal chromosomal aneu- ploidies. (For more information about current screeningltesting options, see Background.) NIPT Test Characteristics Genetic testing using cell-tree fetal DNA DNA from the fetus circulates in maternal blood. Unlike intact fetal cells in maternal blood, which can persist for years after a pregnancy, circu- lating cell.free letal DNA (ceffDNA) results from the breakdown 01 letal cells (mostly placental) and clears trom the maternal system within hours. Fetal DNA detected during a pregnancy, therefore, represents DNA trom the current tetus. Although only about 10-15% of the cell-tree DNA circulating in maternal blood is from the fetus. it can be detected and measured. Quantitative differences in chromosome fragments in maternal blood can be used to distinguish fetuses affected with trisomy 21, and a tew other fetal aneu- plodies, from those that are not affected. When NIPT is perfonned Testing can be done any time a'ter 10 weeks; typically i1is done between 10-22 weeks. Results can take a week or more. Maternal indications for NIPT NIPT technologies have been validated in singleton pregnancies at high risk for trisomy 21 due to: advanced maternal age an abnormal serum screen personal or famil~' history of aneuploidy abno~mal ultrasound At least one laboratory wilt accept samples lhat do not meet these high risk criteria. Additionally, at least one laboratory offers the test in twin pregnancies, and another for Turner syndrome (monosomy X) when t~e fetus presents with a cystic hygroma. Contact individual laboratories for additional information. Risk The testing is non-invasive, involving a maternal blood draw, so the pregnancy is not put at risk for miscarriage 01 other adverse outcomes associated with invasive testing procedures. NIPT Detection Rate and Accuracy At present. NIPT provides information about specific fefal aneuploidies.
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Non-Invasive Prenatal Testing (NIPT) Faetsheet
AntiCipate future directions01 the technology
Critically evaluate NIPTtests and laboralories
Counsel women about theirscreening/testing optionsanj lOterpret and counselab:>ut results
WHAT THIS RESOURCE CAN
HELP YOU ACCOMPLISH:This resource is designedto help you:
Apply NIPT appropriate.ly in the general prenatalscreening/testing paradigmfor trisomy 21
All laboratories offering NIPT
report on trisomy 21 and triso-
my 18. Others may also provide
information aboJt trisomy 13, or
some sex chromosome abnJr-
malities. NIPT does not typically
provide any other genetic infor-
mation about tha genetic consti-
tution of the mother or fetus
Detection rate fortrisomy 21
Al least 99% ct all preg-
nancies with trisomy 21 can
be detected using this test.
However, up to 1 in 100 pre~-
nancies with trisomy 21 will
have a normal result and be
missed on screening.
He false-posi:ive rate is
approximately 0.2%, mean.
ing 1 in about SOD unaffecte::t
pregnancies are reported as 'positive' or 'consistent with' trisomy' 21. For
that reason, it is recommended that CVS or amniocentesis be consid.
ered after an abnormal result to confirm the presence of a chromosome
abnormality .•
Detection rate for trisomy 18
He detection rate for trisomy 18 may be similar to that for trisomy
21; approximately 99% 01 plegnancies with trisomy 18 will be detected
by NIPT. About 1 in 100 pregnancies with trisomy 18 will be missed on
screening.
He false-posi:ive rate is also similar to trisomy 21. About 1 in 500 preg-
nancies unaffected with trisomy 18 will have an abnormal, or positive,
result, so confirmatory testirg is recommended."
Detection of trisomy 13 and sex chromosome abnonnalities
H,ere is less confidence ir NIPT as a screen for trisomy 13 due to
technical issues and the infrequency of the condition. Detection rates
between 79-92% have been reported, meaning between 8 to 21 out of
100 pregnancies with affected fetuses ••••ill be missed. The false-positive
rate may be about 1%. so 1 out of 100 unaffected pregnancies may be
positive lor trisomy 13, so confirmatory testing is recommended.'
Some laboratories may report results for sex chromosomes abnormal.
ities. If testing for sex chrorT()some abnormalities is desired, contact the
NIPT laboratory
"(Actual numters will vary Check wirh the specific laboratory)