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Accuracy of non-invasive prenatal testing using cell-free DNA for detection of Down, Edwards and Patau syndromes: a systematic review and meta-analysis

BMJ open, 2016-01, Vol.6 (1), p.e010002-e010002 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016 This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016 ;ISSN: 2044-6055 ;EISSN: 2044-6055 ;DOI: 10.1136/bmjopen-2015-010002 ;PMID: 26781507

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  • Title:
    Accuracy of non-invasive prenatal testing using cell-free DNA for detection of Down, Edwards and Patau syndromes: a systematic review and meta-analysis
  • Author: Taylor-Phillips, Sian ; Freeman, Karoline ; Geppert, Julia ; Agbebiyi, Adeola ; Uthman, Olalekan A ; Madan, Jason ; Clarke, Angus ; Quenby, Siobhan ; Clarke, Aileen
  • Subjects: Biomarkers - blood ; Chromosome Disorders - diagnosis ; Chromosomes, Human, Pair 13 ; Chromosomes, Human, Pair 18 ; DNA - blood ; Down Syndrome - diagnosis ; Female ; Humans ; Obstetrics and Gynaecology ; Pregnancy ; Prenatal Diagnosis - methods ; Sensitivity and Specificity ; Systematic review ; Trisomy - diagnosis ; Trisomy 13 Syndrome ; Trisomy 18 Syndrome
  • Is Part Of: BMJ open, 2016-01, Vol.6 (1), p.e010002-e010002
  • Description: ObjectiveTo measure test accuracy of non-invasive prenatal testing (NIPT) for Down, Edwards and Patau syndromes using cell-free fetal DNA and identify factors affecting accuracy.DesignSystematic review and meta-analysis of published studies.Data sourcesPubMed, Ovid Medline, Ovid Embase and the Cochrane Library published from 1997 to 9 February 2015, followed by weekly autoalerts until 1 April 2015.Eligibility criteria for selecting studiesEnglish language journal articles describing case–control studies with ≥15 trisomy cases or cohort studies with ≥50 pregnant women who had been given NIPT and a reference standard.Results41, 37 and 30 studies of 2012 publications retrieved were included in the review for Down, Edwards and Patau syndromes. Quality appraisal identified high risk of bias in included studies, funnel plots showed evidence of publication bias. Pooled sensitivity was 99.3% (95% CI 98.9% to 99.6%) for Down, 97.4% (95.8% to 98.4%) for Edwards, and 97.4% (86.1% to 99.6%) for Patau syndrome. The pooled specificity was 99.9% (99.9% to 100%) for all three trisomies. In 100 000 pregnancies in the general obstetric population we would expect 417, 89 and 40 cases of Downs, Edwards and Patau syndromes to be detected by NIPT, with 94, 154 and 42 false positive results. Sensitivity was lower in twin than singleton pregnancies, reduced by 9% for Down, 28% for Edwards and 22% for Patau syndrome. Pooled sensitivity was also lower in the first trimester of pregnancy, in studies in the general obstetric population, and in cohort studies with consecutive enrolment.ConclusionsNIPT using cell-free fetal DNA has very high sensitivity and specificity for Down syndrome, with slightly lower sensitivity for Edwards and Patau syndrome. However, it is not 100% accurate and should not be used as a final diagnosis for positive cases.Trial registration numberCRD42014014947.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 2044-6055
    EISSN: 2044-6055
    DOI: 10.1136/bmjopen-2015-010002
    PMID: 26781507
  • Source: ProQuest One Psychology
    Open Access: DOAJ Directory of Open Access Journals
    BMJ Open Access Journals
    Geneva Foundation Free Medical Journals at publisher websites
    AUTh Library subscriptions: ProQuest Central
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    PubMed Central
    ROAD: Directory of Open Access Scholarly Resources
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