{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:58:15Z","timestamp":1792004295047,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T00:00:00Z","timestamp":1631145600000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the association between low fetal fraction (FF) in prenatal cell\u2010free DNA (cfDNA) testing and adverse pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of participants of the TRIDENT\u20102 study (Dutch nationwide government\u2010supported study offering cfDNA screening for fetal aneuploidies) who received a failed test result due to low FF (&lt;4%) between April 2017 until February 2018. Outcome measures included pregnancy\u2010induced hypertension (PIH), pre\u2010eclampsia (PE), small for gestational age neonates (SGA), spontaneous preterm birth (sPTB), gestational diabetes mellitus (GDM), chromosomal aberrations, and congenital structural anomalies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Test failure due to low FF occurred in 295 women (1.12% of tests performed). Information regarding pregnancy outcomes was available for 96.3% of these women. The incidence of PIH, PE, SGA, sPTB, and GDM was 11.2%, 4.1%, 7.3%, 5.1%, and 14.8%, respectively. The prevalence of chromosomal aberrations and congenital structural anomalies was 1.4% and 4.1%, respectively. Incidences of PIH, PE\u00a0\u2265\u00a034\u00a0weeks of gestation, GDM, and prevalence of aneuploidy and congenital structural anomalies were higher in women with low FF compared to the general Dutch obstetric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low FF is associated with adverse pregnancy outcomes. The value of FF in the prediction of these outcomes needs to be further established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.6034","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:42:08Z","timestamp":1629765728000},"page":"1296-1304","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Low fetal fraction in cell\u2010free DNA testing is associated with adverse pregnancy outcome: Analysis of a subcohort of the TRIDENT\u20102 study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0418-7880","authenticated-orcid":false,"given":"Ellis C.","family":"Becking","sequence":"first","affiliation":[{"name":"Department of Obstetrics Division Woman and Baby Wilhelmina Children's Hospital University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soetinah A. M.","family":"Wirjosoekarto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Division Woman and Baby Wilhelmina Children's Hospital University Medical Center Utrecht  Utrecht The Netherlands"},{"name":"Department of Clinical Science, Intervention and Technology Karolinska Institute  Stockholm Sweden"},{"name":"Center for Fetal Medicine Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9253-5341","authenticated-orcid":false,"given":"Peter G.","family":"Scheffer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Division Woman and Baby Wilhelmina Children's Hospital University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia V. M.","family":"Huiskes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Division Woman and Baby Wilhelmina Children's Hospital University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinka J.","family":"Remmelink","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Division Woman and Baby Wilhelmina Children's Hospital University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7187-4563","authenticated-orcid":false,"given":"Erik A.","family":"Sistermans","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Amsterdam Reproduction\u00a0&amp; Development research institute Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline J.","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Amsterdam UMC University of Amsterdam  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janneke M.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Human Genetics Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3531-0597","authenticated-orcid":false,"given":"Lidewij","family":"Henneman","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Amsterdam Reproduction\u00a0&amp; Development research institute Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7372-4291","authenticated-orcid":false,"given":"Mireille N.","family":"Bekker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Division Woman and Baby Wilhelmina Children's Hospital University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2019.10.005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17484"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41431-018-0271-7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1530\/REP-17-0619"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12331"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5620"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2012.138"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13848"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2013.11.014"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18993"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4779"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2019.04.002"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1700860"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15006"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1407349"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2013.207951"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15851"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1933719115584445"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4541"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000363"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkt992"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5079"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2009.09.008"},{"key":"e_1_2_10_25_1","unstructured":"GroenendaalF KweeA deMirandaE et\u00a0al. 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