{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:04:34Z","timestamp":1791983074563,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:00:00Z","timestamp":1559779200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine factors affecting the rate of failure to obtain a result from cell\u2010free DNA (cfDNA) testing of maternal blood for fetal trisomies 21, 18 and 13 in singleton and twin pregnancies in the first trimester.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective study of 23\u2009495 singleton and 928 twin pregnancies undergoing screening for fetal trisomy by targeted cfDNA testing at 10\u2009+\u20090 to 14\u2009+\u20091 weeks' gestation. Multivariate logistic regression analysis was used to determine significant predictors of failure to obtain a result after first sampling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no result from cfDNA testing after first sampling in 3.4% (798\/23\u2009495) of singletons, 11.3% (91\/806) of dichorionic twins and 4.9% (6\/122) of monochorionic twins. Multivariate logistic regression analysis demonstrated that the risk of test failure, first, increased with increasing maternal age (odds ratio (OR), 1.02; 95% CI, 1.01\u20131.04) and weight (OR, 1.05; 95% CI, 1.04\u20131.05), decreasing gestational age (OR, 0.85; 95% CI, 0.79\u20130.91), serum pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) multiples of the median (MoM) (OR, 0.56; 95% CI, 0.49\u20130.65) and free \u03b2\u2010human chorionic gonadotropin (\u03b2\u2010hCG) MoM (OR, 0.67; 95% CI, 0.60\u20130.74), second, was higher in women of black (OR, 1.72; 95% CI, 1.33\u20132.20) and South Asian (OR, 1.99; 95% CI, 1.56\u20132.52) than those of white racial origin, in dichorionic twin than in singleton pregnancy (OR, 1.75; 95% CI, 1.34\u20132.26) and in pregnancies conceived by <jats:italic>in\u2010vitro<\/jats:italic> fertilization than in those conceived naturally (OR, 3.82; 95% CI, 3.19\u20134.55) and, third, was lower in parous than in nulliparous women (OR, 0.63; 95% CI, 0.55\u20130.74).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal age, weight, racial origin and parity, gestational age, dichorionicity, method of conception and serum levels of free \u03b2\u2010hCG and PAPP\u2010A are independent predictors of cfDNA test failure. The risk of test failure is higher in dichorionic twin than in singleton pregnancies, mainly because a higher proportion of twins are conceived by <jats:italic>in\u2010vitro<\/jats:italic> fertilization and more of the women are nulliparous. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20290","type":"journal-article","created":{"date-parts":[[2019,4,12]],"date-time":"2019-04-12T10:25:20Z","timestamp":1555064720000},"page":"804-809","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["First\u2010trimester screening for trisomies by cfDNA testing of maternal blood in singleton and twin pregnancies: factors affecting test failure"],"prefix":"10.1002","volume":"53","author":[{"given":"S.","family":"Galeva","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"},{"name":"Department of Fetal Medicine Medway Maritime Hospital  Kent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9993-5249","authenticated-orcid":false,"given":"M.\u2009M.","family":"Gil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"},{"name":"School of Health Sciences Universidad Francisco de Vitoria  Pozuelo de Alarc\u00f3n, Madrid Spain"},{"name":"Obstetrics and Gynecology Department Hospital Universitario de Torrej\u00f3n  Torrej\u00f3n de Ardoz, Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Konstantinidou","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-5442","authenticated-orcid":false,"given":"R.","family":"Akolekar","sequence":"additional","affiliation":[{"name":"Department of Fetal Medicine Medway Maritime Hospital  Kent UK"},{"name":"Institute of Medical Sciences Canterbury Christ Church University  Chatham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.\u2009H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17484"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20284"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12504"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000337373"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12331"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15851"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15913"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5332"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep046"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000355527"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14664"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15783"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20160"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1996.07060421.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.01.030"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12299"},{"key":"e_1_2_6_19_1","volume-title":"R. 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