{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:52:46Z","timestamp":1791240766831,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The use of cell free fetal DNA has expanded to include autosomal dominant single gene conditions (cfDNA\u2010SGD). Our aim is to estimate the cost\u2010effectiveness of a cfDNA\u2010SGD panel in a general obstetric population as compared to offering this test only in the setting of anomalies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using TreeAge software, we created a decision\u2010analytic model to compare outcomes of the universal cfDNA\u2010SGD. The screening conditions included in the current panel were separated into tiers (1, 2, 3) based on severity and life expectancy of the conditions. Outcomes included miscarriage after diagnostic procedure, termination, neonatal death, and the outcome of affected livebirth. The cost\u2010effectiveness threshold was set at $100,000 per QALY.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>When applied to a theoretical cohort of 3.7 million individuals, the strategy of universal cfDNA\u2010SGD resulted in approximately 2979 fewer affected livebirths. Given the high costs of care associated with an affected liveborn, universal cfDNA\u2010SGD was projected to be cost\u2010saving in this model until the test cost exceeded $1094. The universal cfDNA\u2010SGD strategy was also projected to yield an additional 10,477 maternal QALYs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this model, and under the assumptions specified, universal cfDNA\u2010SGD was projected to be cost\u2010saving and to yield additional maternal QALYs relative to ultrasound\u2010indicated cfDNA\u2010SGD. These are model\u2010based projections rather than observed outcomes; prospective implementation studies will be needed before any conclusion can be drawn about routine integration into prenatal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70269","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:06:07Z","timestamp":1791237967000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Universal Prenatal cfDNA\u2010Single Gene Disorder Screening for Autosomal Dominant Conditions in a Low\u2010Risk Cohort: A Cost\u2010Effectiveness Analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2910-9662","authenticated-orcid":false,"given":"Megan E.","family":"Bunnell","sequence":"first","affiliation":[{"name":"Department of Maternal Fetal Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3185-4696","authenticated-orcid":false,"given":"Claire H.","family":"Packer","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-7200","authenticated-orcid":false,"given":"Sophie","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Hoffman Sage","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6351"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ogx.0000000000001250"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/hvae189"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23756"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000006192"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2018.07.003"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.05.031"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4774"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6360"},{"key":"e_1_2_11_11_1","unstructured":"Births and Natality U.S. Centers for Disease Control and Prevention (2022) https:\/\/www.cdc.gov\/nchs\/fastats\/births\/html."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4792"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14636"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1462"},{"key":"e_1_2_11_15_1","unstructured":"Cost of Abortion \u201cPlanned Parenthood \u201d 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