Challenges in non-invasive prenatal screening for sub-chromosomal copy number variations using cell-free DNA

Prenat Diagn. 2017 Nov;37(11):1067-1075. doi: 10.1002/pd.5161. Epub 2017 Oct 26.

Abstract

Non-invasive prenatal screening (NIPS) has revolutionized the approach to prenatal fetal aneuploidy screening. Many commercial providers now offer analyses for sub-chromosomal copy number variations (CNVs). Here, we review the use of NIPS in the context of screening for microdeletions and microduplications, issues surrounding the choice of disorders tested for, and the advantages and disadvantages associated with the inclusion of microdeletions to current NIPS. Several studies have claimed benefits; however, we suggest that microdeletions have not demonstrated a low enough false positive rate to be deemed practical or ethically acceptable, especially considering their low positive predictive values. Because a positive NIPS result should be confirmed using diagnostic techniques, and false positive rates are as high as 90% for some microdeletions, diagnostic testing seems preferable when the goal is to maximize the detection of microdeletion or microduplication syndromes.

Publication types

  • Review

MeSH terms

  • Base Sequence
  • Cell-Free Nucleic Acids / analysis*
  • DNA Copy Number Variations*
  • Humans
  • Maternal Serum Screening Tests*
  • Sequence Deletion

Substances

  • Cell-Free Nucleic Acids