1630 Viewed863 Downloaded
Effect of Levothyroxine Sodium Intake on the Fetal Fraction in Non-Invasive Prenatal Testing: A Cross-Sectional Study
Received: 26 Mar 2022 | Received in revised form: 27 May 2022
Accepted: 20 Jun 2022 | Available online: 24 Jun 2022Alper İLERİa, Suna YILDIRIM KARACAa,b, Hande İLERİc, Hakan GÖLBAŞId, Alkım Gülşah ŞAHİNGÖZ YILDIRIMd, Yaşar Bekir KUTBAYe, Altuğ KOÇe, Mehmet ÖZERENd
aClinic of Obstetrics and Gynecology, Tepecik Training and Research Hospital, İzmir, Türkiye
bDepartment of Stem Cell, Ege University Faculty of Medicine, İzmir, Türkiye
cClinic of Family Medicine, Tepecik Training and Research Hospital, İzmir, Türkiye
dClinic of Perinatology, Tepecik Training and Research Hospital, İzmir, Türkiye
eClinic of Medical Genetics, Tepecik Training and Research Hospital, İzmir, Türkiye
JCOG. 2022;32(3):106-10
DOI: 10.5336/jcog.2022-90002
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (
http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Non-invasive prenatal testing (NIPT) and fetal fraction (FF) are shown to be affected by various factors like maternal characteristics or medications. Recently medications are now undergoing evaluation as influencing factors. Still no data are presented on the relation between levothyroxine, NIPT and FF results. The study's aim is to assess the effect of levothyroxine sodium on the FF. Material and Methods: This retrospective case control study was conducted with medical records of pregnant women who underwent NIPT between 2016-2020 at our institution. Women with multiple gestation, body-mass index ≥25, abnormal fetal karyotype, pregnancy with assisted reproductive techniques, those without FF report and non-euthyroid patients were excluded. The pregnant euthyroid women included in the study were divided into two groups: using and not using levothyroxine. Maternal characteristics, FF of the NIPT, TSH, FT4 values and levothyroxine dosing were noted and compared between the two groups. Results: Data were collected from 51 pregnant women using levothyroxine and 102 pregnant women who did not. There was no difference in demographic characteristics, also no significant difference was shown in TSH and FT4 between the groups (p=0.180, p=0.920). The mean FF level in pregnant women using levothyroxine is lower, but the situation did not reach statistical significance (p=0.070). Conclusion: The knowledge of relation between FF and medications is largely based on very limited data. This is the first report of assessing levothyroxine effect on FF percentage in NIPT. Levothyroxine sodium was not confirmed to be associated with any significant change in the FF.
REFERENCES:- Lo YM, Corbetta N, Chamberlain PF, Rai V, Sargent IL, Redman CW, et al. Presence of fetal DNA in maternal plasma and serum. Lancet. 1997;350(9076):485-7. [Crossref] [PubMed]
- Sekizawa A, Samura O, Zhen DK, Falco V, Farina A, Bianchi DW. Apoptosis in fetal nucleated erythrocytes circulating in maternal blood. Prenat Diagn. 2000;20(11):886-9. [Crossref] [PubMed]
- Guibert J, Benachi A, Grebille AG, Ernault P, Zorn JR, Costa JM. Kinetics of SRY gene appearance in maternal serum: detection by real time PCR in early pregnancy after assisted reproductive technique. Hum Reprod. 2003;18(8):1733-6. [Crossref] [PubMed]
- Wang E, Batey A, Struble C, Musci T, Song K, Oliphant A. Gestational age and maternal weight effects on fetal cell-free DNA in maternal plasma. Prenat Diagn. 2013;33(7):662-6. [Crossref] [PubMed]
- Scott FP, Menezes M, Palma-Dias R, Nisbet D, Schluter P, da Silva Costa F, et al. Factors affecting cell-free DNA fetal fraction and the consequences for test accuracy. J Matern Fetal Neonatal Med. 2018;31(14):1865-72. [Crossref] [PubMed]
- Lee TJ, Rolnik DL, Menezes MA, McLennan AC, da Silva Costa F. Cell-free fetal DNA testing in singleton IVF conceptions. Hum Reprod. 2018;33(4):572-8. [Crossref] [PubMed]
- Ashoor G, Syngelaki A, Poon LC, Rezende JC, Nicolaides KH. Fetal fraction in maternal plasma cell-free DNA at 11-13 weeks' gestation: relation to maternal and fetal characteristics. Ultrasound Obstet Gynecol. 2013;41(1):26-32. [Crossref] [PubMed]
- Silva JF, Ocarino NM, Serakides R. Thyroid hormones and female reproduction. Biol Reprod. 2018;99(5):907-21. [Crossref] [PubMed]
- Silva JF, Ocarino NM, Serakides R. Maternal thyroid dysfunction affects placental profile of inflammatory mediators and the intrauterine trophoblast migration kinetics. Reproduction. 2014;147(6):803-16. [Crossref] [PubMed]
- Koc A, Ozer Kaya O, Ozyilmaz B, Kutbay YB, Kirbiyik O, Ozdemir TR, et al. Targeted fetal cell-free DNA screening for aneuploidies in 4,594 pregnancies: Single center study. Mol Genet Genomic Med. 2019;7(7):e00678. [Crossref] [PubMed] [PMC]
- Bulur O, Atak Z, Ertugrul DT, Beyan E, Gunakan E, Karakaya S, et al. Trimester-specific reference intervals of thyroid function tests in Turkish pregnants. Gynecol Endocrinol. 2020;36(5):413-6. [Crossref] [PubMed]
- Hui L, Bianchi DW. Fetal fraction and noninvasive prenatal testing: What clinicians need to know. Prenat Diagn. 2020;40(2):155-63. [Crossref] [PubMed]
- Taglauer ES, Wilkins-Haug L, Bianchi DW. Review: cell-free fetal DNA in the maternal circulation as an indication of placental health and disease. Placenta. 2014;35 Suppl(Suppl):S64-8. [Crossref] [PubMed] [PMC]
- Kinnings SL, Geis JA, Almasri E, Wang H, Guan X, McCullough RM, et al. Factors affecting levels of circulating cell-free fetal DNA in maternal plasma and their implications for noninvasive prenatal testing. Prenat Diagn. 2015;35(8):816-22. [Crossref] [PubMed]
- Silva JF, Ocarino NM, Serakides R. Placental angiogenic and hormonal factors are affected by thyroid hormones in rats. Pathol Res Pract. 2015;211(3):226-34. [Crossref] [PubMed]
- Hui L. Noninvasive prenatal testing for aneuploidy using cell-free DNA - New implications for maternal health. Obstet Med. 2016;9(4):148-52. [Crossref] [PubMed] [PMC]
- Grömminger S, Erkan S, Schöck U, Stangier K, Bonnet J, Schloo R, et al. The influence of low molecular weight heparin medication on plasma DNA in pregnant women. Prenat Diagn. 2015;35(11):1155-7. [Crossref] [PubMed]
- Ma GC, Wu WJ, Lee MH, Lin YS, Chen M. Low-molecular-weight heparin associated with reduced fetal fraction and subsequent false-negative cell-free DNA test result for trisomy 21. Ultrasound Obstet Gynecol. 2018;51(2):276-7. [Crossref] [PubMed]
- 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. Prenat Diagn. 2019;39(5):361-8. [Crossref] [PubMed]
- Hui CY, Tan WC, Tan EL, Tan LK. Repeated failed non-invasive prenatal testing in a woman with immune thrombocytopenia and antiphospholipid syndrome: lessons learnt. BMJ Case Rep. 2016;2016:bcr2016216593. [Crossref] [PubMed] [PMC]
- Hui L, Pertile M, Tassone M, Bruno D. Minimal impact of maternal intravenous immunoglobulin infusion on cell-free DNA sequencing for fetal aneuploidy. Ultrasound Obstet Gynecol. 2016;48(2):250. [Crossref] [PubMed]