{"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":1792004295750,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["24K20343"],"award-info":[{"award-number":["24K20343"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the association between fetal fraction (FF) on non\u2010invasive prenatal testing (NIPT) and pregnancy\u2010related complications using a large sample to support improved prenatal management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included women with singleton pregnancies and negative NIPT results between January 2015 and March 2022 as part of the Japan Multicenter Study. Chi\u2010square tests and binary logistic regression analyses were used to assess the association between FF and pregnancy\u2010related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 40,716 responses were analyzed. No significant association was found between FF and placental abruption (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (1)\u00a0=\u00a02.84,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.09). Women in the low FF group (FF &lt;\u00a010.27%, &lt;\u00a025th percentile) had higher risks of fetal demise, adjusted OR\u00a0=\u00a01.79, 95% CI [1.31, 2.43]), preterm birth (adjusted OR\u00a0=\u00a01.63, 95% CI [1.30, 2.06]), fetal growth restriction (FGR) (adjusted OR\u00a0=\u00a01.50, 95% CI [1.10, 2.05]), and hypertensive disorders of pregnancy (HDP) (adjusted OR\u00a0=\u00a01.44, 95% CI [1.24, 1.66]). No significant differences were observed for gestational diabetes mellitus (GDM) (adjusted OR\u00a0=\u00a01.13, 95% CI [0.99, 1.30],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.081).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low FF on NIPT is associated with an increased risk of several pregnancy complications, highlighting the need for careful management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.6900","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T03:15:05Z","timestamp":1759202105000},"page":"1572-1579","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical Implications of Low Cell\u2010Free DNA Fetal Fraction in Non\u2010Invasive Prenatal Testing: A Retrospective Cohort Study of 40,716 Pregnancies"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2438-071X","authenticated-orcid":false,"given":"Kayono","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Department of Clinical Genetics Iwate Medical University School of Medicine  Morioka Iwate Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Suzumori","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Iwate Medical University School of Medicine  Morioka Iwate Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5396-8881","authenticated-orcid":false,"given":"Kiyonori","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Yamada","sequence":"additional","affiliation":[{"name":"Division of Clinical Genetics Hokkaido University Hospital  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimasa","family":"Kamei","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Saitama Medical University School of Medicine  Iruma Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8997-464X","authenticated-orcid":false,"given":"Hideaki","family":"Sawai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hyogo College of Medicine  Nishinomiya Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruka","family":"Hamanoue","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Yokohama City University Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7249-1537","authenticated-orcid":false,"given":"Osamu","family":"Samura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jikei University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Wada","sequence":"additional","affiliation":[{"name":"Center of Maternal\u2010Fetal Neonatal and Reproductive Medicine National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Murotsuki","sequence":"additional","affiliation":[{"name":"Department of Maternal and Fetal Medicine Tohoku University Graduate School of Medicine Miyagi Children's Hospital  Sendai Miyagi 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhisa","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shikoku Medical Center for Children and Adults  Zentsuji Kagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6520-902X","authenticated-orcid":false,"given":"Shun","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Fukushima Medical University  Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Ida","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kobe Adventist Hospital  Kobe Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Toyama  Toyama Toyama 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