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

Maggie Kuhlmann-Capek, Giuseppe Chiossi, Prapti Singh, Luis Monsivais, Violetta Lozovyy, Lauren Gallagher, Nathan Kirsch, Elizabeth Florence, Victoria Petruzzi, Jeffrey Chang, Sofia Buenaventura, Paul Walden, Benjamin Gardner, Mary Munn, Maged Costantine

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
JournalPrenatal Diagnosis
DOIs
StatePublished - Jan 1 2019

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Pregnancy
Obesity
Metformin
DNA
Gestational Age
Counseling
Pregnant Women
Cohort Studies
Multivariate Analysis
Retrospective Studies
Mothers

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Genetics(clinical)

Cite this

Kuhlmann-Capek, M., Chiossi, G., Singh, P., Monsivais, L., Lozovyy, V., Gallagher, L., ... Costantine, M. (2019). Effects of medication intake in early pregnancy on the fetal fraction of cell-free DNA testing. Prenatal Diagnosis. https://doi.org/10.1002/pd.5436

Effects of medication intake in early pregnancy on the fetal fraction of cell-free DNA testing. / Kuhlmann-Capek, Maggie; Chiossi, Giuseppe; Singh, Prapti; Monsivais, Luis; Lozovyy, Violetta; Gallagher, Lauren; Kirsch, Nathan; Florence, Elizabeth; Petruzzi, Victoria; Chang, Jeffrey; Buenaventura, Sofia; Walden, Paul; Gardner, Benjamin; Munn, Mary; Costantine, Maged.

In: Prenatal Diagnosis, 01.01.2019.

Research output: Contribution to journalArticle

Kuhlmann-Capek, M, Chiossi, G, Singh, P, Monsivais, L, Lozovyy, V, Gallagher, L, Kirsch, N, Florence, E, Petruzzi, V, Chang, J, Buenaventura, S, Walden, P, Gardner, B, Munn, M & Costantine, M 2019, 'Effects of medication intake in early pregnancy on the fetal fraction of cell-free DNA testing', Prenatal Diagnosis. https://doi.org/10.1002/pd.5436
Kuhlmann-Capek M, Chiossi G, Singh P, Monsivais L, Lozovyy V, Gallagher L et al. Effects of medication intake in early pregnancy on the fetal fraction of cell-free DNA testing. Prenatal Diagnosis. 2019 Jan 1. https://doi.org/10.1002/pd.5436
Kuhlmann-Capek, Maggie ; Chiossi, Giuseppe ; Singh, Prapti ; Monsivais, Luis ; Lozovyy, Violetta ; Gallagher, Lauren ; Kirsch, Nathan ; Florence, Elizabeth ; Petruzzi, Victoria ; Chang, Jeffrey ; Buenaventura, Sofia ; Walden, Paul ; Gardner, Benjamin ; Munn, Mary ; Costantine, Maged. / Effects of medication intake in early pregnancy on the fetal fraction of cell-free DNA testing. In: Prenatal Diagnosis. 2019.
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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.",
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AU - Monsivais, Luis

AU - Lozovyy, Violetta

AU - Gallagher, Lauren

AU - Kirsch, Nathan

AU - Florence, Elizabeth

AU - Petruzzi, Victoria

AU - Chang, Jeffrey

AU - Buenaventura, Sofia

AU - Walden, Paul

AU - Gardner, Benjamin

AU - Munn, Mary

AU - Costantine, Maged

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N2 - 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.

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