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Licensed Unlicensed Requires Authentication Published by De Gruyter April 2, 2020

Can fetal fractions in the cell-free DNA test predict the onset of fetal growth restriction?

  • Duygu Adiyaman ORCID logo EMAIL logo , Bahar Konuralp Atakul , Melda Kuyucu , Gizem Toklu , Hakan Golbasi , Altug Koc , Ozge Ozer Kaya , Taha Resid Ozdemir and Atalay Ekin



To investigate the possible predictive value of fetal fraction in the cell-free DNA (cfDNA) test in pregnancies with early- and late-onset fetal growth restriction (FGR).


This retrospective study comprised 247 women who were screened using the cfDNA test for aneuploidies during the first or second trimester and had deliveries at our institution from January 2016 to December 2019. The fetal fractions of women with early- (n = 14) and late-onset (n = 83) FGR and those with uncomplicated pregnancies (n = 150) were compared.


The median fetal fractions for the early-onset FGR, late-onset FGR, and control groups were 5.7 [interquartile range (IQR) 2.65], 7 (IQR 5), and 7.35 (IQR 3.65), respectively. The fetal fractions were significantly lower in the early-onset FGR group than in the late-onset FGR and control groups (P = 0.047 and P = 0.037, respectively). There was no difference in fetal fractions between the late-onset FGR and control groups (P = 1.00).


As a placenta-related disease, early-onset FGR had lower fetal fractions in the cfDNA test than uncomplicated pregnancies. For clinical use, lower fetal fractions can contribute as a biomarker for screening asymptomatic women for possible placenta-related diseases, such as early-onset FGR. However, more studies are needed to define the “lower” limit.

Corresponding author: Duygu Adiyaman, MD, Tepecik Training and Research Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Izmir, Turkey; and present address: Güney Mah., 1140/1. Sk. No: 1, 35180 Yenişehir, Konak, Izmir, Turkey, Tel.: 0090-5337232809

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


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Received: 2020-01-10
Accepted: 2020-03-09
Published Online: 2020-04-02
Published in Print: 2020-04-28

©2020 Walter de Gruyter GmbH, Berlin/Boston

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