Increased fetal fraction is associated with the incidence of birth
weight discordance and selective fetal growth restriction:a
retrospective cohort study
Abstract
Objective To test the hypothesis that the fetal fraction in
twin pregnancy would reflect birthweight discrepancy. Design
Retrospective cohort study. Setting International Peace
Maternity and Child Health Hospital in Shanghai, China
Population We included 237 twin pregnancies undergoing cfDNA
screening for aneuploidy and delivered at International Peace Maternity
and Child Health Hospital in Shanghai, China between January 2018 to
December 2021. Exclusion criteria including abnormal NIPT results,
fetal demise or structural abnormalities. Methods All women
with twin pregnancies were offered a scan to determine chorionicity as
well as first-trimester nuchal translucency (NT) at 11
+0-13 +6 weeks. Dichorionic was
confirmed when ultrasound assessment clearly indicates two placentas.
The twin peak sign is used to distinguish chorionicity if only one
placenta is visualized. Main Outcome Measures Fetal fraction
and birth weight of the new borns were collected. Relationships between
fetal fraction and birth weight discordance or sFGR were analysed.
Results Fetal fraction was positively correlated with the
difference of birth weight (β=0.004, 95%CI:
0.001~0.006). Higher fetal fraction was significantly
associated with the increased risk of birthweight discordance of 20%
(adjusted OR:1.073, 95%CI: 1.009~1.142) and 25%
(adjusted OR:1.092, 95%CI: 1.006~1.185) and
sIUGR(adjusted OR:1.130, 95%CI: 1.038~1.231). We
obtained the optimum cut-off point of fetal fraction ≥ 11.790, ≥ 14.800
and ≥ 14.800 for birthweight discordance of 20% and 25% and sFGR,
respectively. Conclusion This study shown that fetal fraction
was positively correlated with the difference of birth weight. Fetal
fraction could be used as a biomarker in predating birth weight
discordance and sFGR, and help to make individualized clinical
monitoring plans for twin pregnancies.