WEDNESDAY, Nov. 9 (HealthDay News) -- In what a team of
scientists says is a first, the researchers appear to have
successfully screened for a rare form of fetal abnormality by means
of a completely noninvasive blood test.
By performing a DNA analysis on a blood sample from a
prospective mother, the team was able to accurately identify a
specific chromosomal irregularity called "fetal microdeletion
syndrome" in the unborn child, reported investigators at the
Magee-Womens Research Institute (MWRI) at the University of
Pittsburgh Medical Center.
In so doing, the researchers indicated it may one day be
possible to avoid the use of much more invasive -- and thereby
riskier -- standard diagnostic techniques, such as
amniocentesis.
"If a fetal anomaly is suspected, mothers are usually offered an invasive screening procedure," said David Peters, head of the MWRI team and an associate professor in the department of obstetrics, gynecology and reproductive sciences.
"But there is a pretty significant, if small, level of risk to the health of the fetus associated with those tests. So there's been a strong push to try and reduce that risk," he noted.
"So I think the most compelling point," said Peters, "is that we have been able to illustrate a proof of concept. We have shown that you can identify these sorts of abnormalities without having to
collect a physical sample from the baby or the placenta."
Peters and his colleagues discussed their findings in a letter
published in the Nov. 10 issue of the
New England Journal of Medicine.
Although this may be the first such test for this particular
type of defect, maternal blood tests are also being developed for
other fetal anomalies such as Down syndrome, as reported by
HealthDay earlier this year. That study, conducted by Greek
researchers, was published in the March 6 online edition of
Nature Medicine.
According to the March of Dimes, roughly one in every 150
American babies is born with a structural or numerical chromosomal
abnormality.
Such abnormalities can develop during egg or sperm cell growth,
both before and after conception. Oftentimes they give rise to
severe mental or physical defects, including Down syndrome and
spina bifida.
Typically, chromosomal abnormalities are first identified during
pregnancy by invasive diagnostic procedures.
Chorionic villus sampling is one option, involving the
extraction of cellular material found in tiny finger-shaped growths
located in the placenta. The procedure requires a catheter or long
needle, and is usually conducted in the latter part of the first
trimester.
The other option is amniocentesis, involving the extraction of a
small amount of amniotic fluid surrounding the fetus for subsequent
DNA analysis. The procedure is usually performed during the second
trimester, and entails the use of a local anesthetic and the
insertion of a needle through the mother's abdominal wall, uterus
and amniotic sac.
But these invasive methods involve some risk, as fetal limb
damage, fetal respiratory distress and even miscarriage can occur
as a result.
To explore the potential of a less-invasive screening tool, the
MWRI team focused on a couple who had already previously had a
child born with physical and developmental abnormalities. In that
case, the culprit was the absence (or "deletion") of specific
chromosomal DNA, a condition that the child had inherited from his
father.
At 21 weeks into her current pregnancy, the mother underwent
traditional amniocentesis, which confirmed that her unborn child
also suffered from the same rare fetal microdeletion syndrome.
In turn, at 35 weeks into the pregnancy the team drew a maternal
blood sample and conducted a series of high-tech genetic sequencing
tests. This time, no fetal tissue or blood was extracted.
The result: The non-invasive blood test successfully arrived at
the same diagnosis as the invasive amniocentesis.
Peters acknowledged that the 35-week mark is late for prenatal
screenings, but added that the time frame was appropriate for a
comparative analysis of a new screening approach that is still in
its infancy.
"I'm not a clinician, but I think it's fair to say that at this point we're a long way away from having something that would practically be able to replace amniocentesis," he cautioned.
Dr. De-Kun Li, a reproductive and perinatal epidemiologist in
the division of research at Kaiser Permanente Northern California,
in Oakland, said that while the risk associated with invasive
screening is very low, an equally accurate risk-free blood test
would be ideal.
"I believe the risk of spontaneous abortion or miscarriage due to an amniocentesis is 0.5 percent," he noted. "And the rate has been going down, because we are now much more technologically savvy. But of course a blood test would be noninvasive, cheaper and less risky. The question is, will the accuracy be the same? If so, then of course we'll go with the blood test. No questions asked. But that's a big 'if.'"
More information
For more on birth defects and chromosomal abnormalities, visit
the
March of Dimes.