Prenatal Cell-Free DNA Testing: How Genomic Screening Transformed Prenatal Care
This NEJM review charted the rapid translation of prenatal cfDNA sequencing from proof-of-principle to global clinical adoption, with 4-6 million pregnant women tested by late 2017 for fetal aneuploidy. The authors examined lessons learned from large-scale implementation, impacts on prenatal clinical care pathways, and emerging ethical considerations as the technology expands to broader genomic screening.
The original study
Sequencing of Circulating Cell-free DNA during Pregnancy.
- Authors
- Bianchi DW, Chiu RWK
- Journal
- The New England journal of medicine
- Type
- Journal Article, Review
- PMID
- 30067923
Original abstract
Sequence analysis of cell-free DNA (cfDNA) fragments that circulate in the blood of pregnant women, along with the translation of this method into screening for fetal chromosome abnormalities, is a success story of modern genomic medicine. In less than a decade, prenatal cfDNA testing has gone from small, proof-of-principle studies to a global transformation of prenatal care. As of late 2017, a total of 4 million to 6 million pregnant women had had DNA from their plasma analyzed to screen for fetal aneuploidy. The exponential growth of the test has been a function of the role of the biotechnology industry in its development and marketing. Here we review what has been learned from the wide-scale implementation of this testing, how it has changed prenatal clinical care, and what ethical concerns have arisen, and we speculate about what lies ahead.