Effects of medication intake in early pregnancy on the fetal fraction of cell‐free DNA testing

Abstract

Objectives:To determine the association between medications intake in early pregnancy and variation in the fetal fraction (FF) in pregnant women undergoing cell-free DNA (cfDNA) testing. Methods:We performed a retrospective cohort study of women (n = 1051) undergoing cfDNA testing at an academic center. The exposed group included women taking medications (n = 400; 38.1%), while the nonexposed group consisted of women taking no medications (n = 651; 61.9%). Our primary outcome was FF. We performed univariate and multivariate analyses as appropriate. Results:The FFs were 8.8% (6.6-12.1), 8.7% (6.3-11.6), and 7.7% (5.1-9.3) among women taking 0, 1, and two or more medications, respectively (P < 0.01). Using multivariable linear mixed effects model, the mean FF was significantly lower among those taking two or more medications compared with the nonexposed group. FF was directly correlated with gestational age at the time of cfDNA testing and inversely correlated with maternal obesity. Exposure to metformin was associated with 1.8% (0.2-3.4) lower mean FF when compared with the nonexposed group (P = 0.02). Obesity and intake of two or more medications were associated with higher hazard ratio of having a low FF less than 4%.Conclusions: Exposure to metformin or two or more medications was associated with decreased FF, and obesity is associated with delay in achieving adequate FF percentage. These findings should be considered while counseling patients on test limitations.

Factors Affecting the Fetal Fraction in Noninvasive Prenatal Screening: A Review

“…The FF was significantly lower in the group taking two or more drugs than in the group not taking any drugs. The group taking metformin had a 1.8% decrease in the FF (42). In addition, the FF present in blood samples taken immediately after completing a cycling exercise was significantly lower than that taken before cycling, with a decreased range of 1-17% (43).…”

Effect of Levothyroxine Sodium Intake on the Fetal Fraction in Non-Invasive Prenatal Testing: A Cross-Sectional Study

“…18 Nevertheless, others have shown acetyl salycillic acid or heparin did not affect FF. 19 The same study stated metformin might be correlated with lower FF. 19 Although metformin was shown to reduce the secretions leading to proliferation and metabolism, medication was not found directly associated with the FF.…”

“…19 The same study stated metformin might be correlated with lower FF. 19 Although metformin was shown to reduce the secretions leading to proliferation and metabolism, medication was not found directly associated with the FF. Another repeated failed NIPT in a woman with an autoimmune disease case demonstrated the patient taking acetyl salycillic acid, prednisolone, and LMWH.…”

<p>Pharmacogenomic Testing In Pediatrics: Navigating The Ethical, Social, And Legal Challenges</p>

“…However, with the rapid expansion of non-invasive, cell-free fetal DNA testing,134 single gene or multiple gene PGx panel testing may be possible in the near future. Some data have indicated that maternal medication use may impact the quantity of cell-free fetal DNA available 135…”