The Effect of Elevated Alanine Transaminase on Non-invasive Prenatal Screening Failures

Frontiers in Medicine

article

Ping Chen¹  Longwei Qiao²  Sheng Zhang³  Jieyu Jin³  Jun Cao³  Yuqiong Zhang⁴  Haoyu Tang²  Zheng Yu²  Jingye Shi²  JingPing Yin³  Yuting Liang³  Xiao Wu¹ 

[1] Department of Obstetrics, School of Gusu, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University;Center for Reproduction and Genetics, School of Gusu, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University;Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University;Department of Medical Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University

关键词: non-invasive prenatal screening;    fetal fraction;    cell-free DNA;    ALT;    multivariable linear regression models;   

DOI  :  10.3389/fmed.2022.875588

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective To determine the effects of alanine transaminase (ALT) levels on the screening failure rates or “no calls” due to low fetal fraction (FF) to obtain a result in non-invasive prenatal screening (NIPS). Methods NIPS by sequencing and liver enzyme measurements were performed in 7,910 pregnancies at 12–26 weeks of gestation. Univariate and multivariable regression models were used to evaluate the significant predictors of screening failure rates among maternal characteristics and relevant laboratory parameters. Results Of the 7,910 pregnancies that met the inclusion criteria, 134 (1.69%) had “no calls.” Multiple logistic regression analysis demonstrated that increased body mass index, ALT, prealbumin, albumin levels, and in vitro fertilization (IVF) conception rates were independently associated with screening failures. The test failure rate was higher (4.34 vs. 1.41%; P 40 U/L. In particular, IVF pregnancies with an ALT level of >40 U/L had a higher test failure rate (9.52%). Compared with that for an ALT level of ≤10 U/L, the adjusted odds ratio of “no calls” for ALT levels of 10–20, 21–40, and >40 U/L was 1.204 [95% confidence interval (CI), 0.709–2.045], 1.529 (95% CI, 0.865–2.702), and 2.764 (95% CI, 1.500–5.093) ( P trend < 0.001), respectively. Conclusions Increased ALT and IVF conceptions were associated with a higher screening failure rates in NIPS. Therefore, a feasible strategy to adjust these factors to reduce the probability of “no calls” due to low FF would be of great clinical significance.

【 授权许可】

CC BY