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Fetal DNA in maternal plasma as a screening variable for preeclampsia. A preliminary nonparametric analysis of
Antonio Farina1, Akihiko Sekizawa, Yumi Sugito
1Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan. farina@alma.unibo.it
Objective:
Our objective was to examine whether plasma fetal DNA can be used as a screening variable in those women who developed preeclampsia but without any clinical symptom at the time of blood draw.
Methods:
Fetal DNA was extracted from 1.5-mL plasma samples, and the DYS14 gene was analyzed by real-time quantitative polymerase chain reaction. Plasma collected and frozen from six women were each paired with five matched control samples of identical specimen type from gravid women carrying a presumed normal male fetus. Matched rank-sum analysis and nonparametric receiver operating characteristic (ROC) curves analysis of estimated multiples of median (MoM) were used for calculating detection rate (DR) and false-positive rate (FPR).
Results:
The mean observed rank of 5.08 in the cases was significantly higher than the expected 3.18 (p-value = 0.013). Pregnancies that will develop a preeclampsia exhibit 2.39-fold higher levels of maternal plasma cell-free fetal DNA compared to matched controls. DR was 33 and 50% at an FPR of 5 and 10% respectively.
Conclusions:
The estimated DR allows to consider fetal DNA as a potential variable to predict preeclampsia in a low-risk population. Further studies will be addressed to calculate a parametric statistical algorithm and to estimate a proper posterior risk of the disease by means of fetal DNA alone or combined with other markers.
