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Diagnostic Value of Cell-Free DNA Fetal Fraction in Patients With Prenatally Suspected Placenta Accreta Spectrum
Danielle Chirumbole1, Christian M Parobek1, Alex Tai1
1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, Texas, USA.
Objective:
The purpose of this study was to investigate the relationship between fetal fraction (FF) and placenta accreta spectrum (PAS) pathology in patients with prenatally suspected PAS.
Methods:
This was a case-control study utilizing a database of pregnancies with suspected or proven PAS delivered between 6/2012 and 7/2024 at a single institution. Pregnancies were excluded if FF was not reported. The primary outcome was mean FF in pregnancies with a final clinical diagnosis of low FIGO grade (no PAS or FIGO1-2) versus high FIGO grade (FIGO3) placenta accreta. Results were reported as mean FF ± standard error of the mean. Adjusted means were also reported after assessing confounders.
Results:
Of the 468 pregnancies assessed, 128 met the full inclusion criteria. While the unadjusted mean FF in the low-grade group did not differ from the high-grade group (9.6% ± 0.49, n = 81 vs. 10.7% ± 0.64, n = 47; p = 0.22), the adjusted mean FF in the low-grade group was significantly lower than that in the high-grade group (9.3% ± 0.48 vs. 11.1% ± 0.64; p = 0.03).
Conclusions:
While FF alone is unlikely to be clinically useful in predicting PAS pathology, NIPT results have the potential to improve the diagnostic precision of other clinical tools for PAS prediction.
