Clinical experience with a single-nucleotide polymorphism-based non-invasive prenatal test for five clinically significant microdeletions

Clin Genet. 2018 Feb;93(2):293-300. doi: 10.1111/cge.13098. Epub 2017 Nov 17.

Abstract

Single-nucleotide polymorphism (SNP)-based non-invasive prenatal testing (NIPT) can currently predict a subset of submicroscopic abnormalities associated with severe clinical manifestations. We retrospectively analyzed the performance of SNP-based NIPT in 80 449 referrals for 22q11.2 deletion syndrome and 42 326 referrals for 1p36, cri-du-chat, Prader-Willi, and Angelman microdeletion syndromes over a 1-year period, and compared the original screening protocol with a revision that reflexively sequenced high-risk calls at a higher depth of read. The prevalence of these microdeletion syndromes was also estimated in the referral population. The positive predictive value of the original test was 15.7% for 22q11.2 deletion syndrome, and 5.2% for the other 4 disorders combined. With the revised protocol, these values increased to 44.2% for 22q11.2 and 31.7% for the others. The 0.33% false-positive rate (FPR) for 22q11.2 deletion syndrome decreased to 0.07% with the revised protocol. Similarly, the FPR for the other 4 disorders combined decreased from 0.56% to 0.07%. Minimal prevalences were estimated to be 1 in 1255 for 22q11.2 deletion syndrome and 1 in 1464 for 1p36, cri-du-chat, and Angelman syndromes combined. Our results show that these microdeletions are relatively common in the referral population, and that the performance of SNP-based NIPT is improved with high-depth resequencing.

Keywords: aneuploidy; microdeletion; non-invasive prenatal testing; single-nucleotide polymorphism; submicroscopic chromosome abnormality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Angelman Syndrome / diagnosis*
  • Angelman Syndrome / genetics
  • Angelman Syndrome / pathology
  • Chromosome Deletion
  • DiGeorge Syndrome / diagnosis*
  • DiGeorge Syndrome / genetics
  • DiGeorge Syndrome / pathology
  • Female
  • Fetus / pathology
  • Genetic Testing*
  • Humans
  • Polymorphism, Single Nucleotide / genetics*
  • Pregnancy
  • Prenatal Diagnosis / methods
  • Young Adult