{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:56:24Z","timestamp":1791381384142,"version":"4.3.3"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to develop a predictive model to estimate the likelihood of achieving a sufficient fetal fraction (FF) for non\u2010invasive prenatal testing (NIPT) based on maternal characteristics such as age, body mass index (BMI), gestational age, gravida, parity, and uterine leiomyoma volume, if present.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This retrospective study include singleton pregnancies with normal NIPT results and complete data from a tertiary hospital. Maternal and clinical variables are analyzed. Machine learning models (Decision Tree, Random Forest, XGBoost) are trained to classify FF as sufficient (\u2265 4%) or insufficient. The best\u2010performing model (XGBoost) is interpreted using SHAP values. Additionally, the impact of uterine leiomyoma volume on FF is demonstrated through scenario\u2010based analyses derived from the model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>XGBoost achieves the highest prediction accuracy (0.89). SHAP analysis shows that age, BMI, and gestational age are most influential, followed by uterine leiomyoma volume. Scenario\u2010based simulations on 24 patients with both uterine leiomyoma and insufficient FF demonstrate that reducing uterine leiomyoma volume often led to a predicted improvement in FF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Uterine leiomyoma volume is identified as a significant factor influencing FF levels in NIPT. This predictive modeling has the potential to support clinical decision\u2010making in cases where low FF poses challenges to effective patient management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70162","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T02:20:29Z","timestamp":1776997229000},"page":"1018-1027","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fetal Fraction and Uterine Leiomyoma Volume: New Insights From Interpretable Modeling"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4871-0621","authenticated-orcid":false,"given":"\u0130lker","family":"U\u00e7ar","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics Tepecik Training and Research Hospital  \u0130zmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8290-2248","authenticated-orcid":false,"given":"G\u00f6rkem","family":"Sar\u0131yer","sequence":"additional","affiliation":[{"name":"Department of Business Administration Faculty of Business Ya\u015far University  \u0130zmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7190-087X","authenticated-orcid":false,"given":"Esra","family":"Yaprak U\u00e7ar","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Tepecik Training and Research Hospital  \u0130zmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rumeysa Nur","family":"\u00c7a\u011f\u0131ran","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Tepecik Training and Research Hospital  \u0130zmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emine","family":"Demirel","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Tepecik Training and Research Hospital  \u0130zmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14636"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20201"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004084"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15887"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2016.97"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6023"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12331"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000002752"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.29098"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23763"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2017.277517"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010022\u201005224\u20107"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5788"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4615"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.33889\/ijmems.2023.8.6.066"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10791\u2010025\u201009590\u20106"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1515\/bams\u20102018\u20100044"},{"key":"e_1_2_11_19_1","volume-title":"C4.5: Programs for Machine Learning","author":"Quinlan J. R.","year":"2014"},{"key":"e_1_2_11_20_1","volume-title":"Random forests\u2010random Features","author":"Breiman L.","year":"1999"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ribaf.2024.102706"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1145\/2939672.2939785"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1515\/9781400881970-018"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.omega.2024.103105"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/gim.0b013e3182368a0e"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005504"},{"key":"e_1_2_11_27_1","article-title":"A Unified Approach to Interpreting Model Predictions","volume":"30","author":"Lundberg S. M.","year":"2017","journal-title":"Advances in Neural Information Processing Systems"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0b013e318197bbaf"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/der293"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.07.005"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100466"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004833"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.17386"}],"container-title":["Prenatal Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.70162","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pd.70162","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.70162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:24:19Z","timestamp":1791379459000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pd.70162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,23]]},"references-count":32,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/pd.70162"],"URL":"https:\/\/doi.org\/10.1002\/pd.70162","archive":["Portico"],"relation":{},"ISSN":["0197-3851","1097-0223"],"issn-type":[{"value":"0197-3851","type":"print"},{"value":"1097-0223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,23]]},"assertion":[{"value":"2025-11-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}