{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T11:41:42Z","timestamp":1777030902117,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Uterine fibroids are monoclonal tumors, which are often genetically abnormal  and  associated with false\u2010positive genome\u2010wide cell\u2010free DNA (cfDNA) screening results, particularly when large. It is plausible that fibroids may also increase the risk of cfDNA failure by affecting fetal fraction or due to their genetic anomalies confounding cfDNA algorithms. We aimed to investigate a possible association between fibroids and cfDNA non\u2010informative results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of women undergoing cfDNA screening for fetal chromosomal abnormalities between 2013 and 2020, comparing pregnancies with <jats:italic>vs<\/jats:italic> without uterine fibroids recorded on any obstetric ultrasound before 24\u2009weeks' gestation. Univariable and multivariable logistic regression models were used to investigate the association between fibroids and cfDNA failure, adjusting for gestational age, maternal age, weight and height at blood sampling, mode of conception, multiple gestation and test platform (chromosome\u2010selective or genome\u2010wide). Analyses were stratified according to the number of fibroids and total fibroid volume. The impact of fibroids on fetal fraction was assessed using linear regression, adjusting for the same covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 19\u2009818 pregnancies undergoing cfDNA screening, fibroids were reported in 2038 (10.28%) and cfDNA failure at the first screening attempt occurred in 228 (1.15%) pregnancies. Non\u2010informative results occurred in 1.96% of pregnancies with fibroids and 1.06% of pregnancies without fibroids (adjusted odds ratio (aOR), 2.40 (95%\u2009CI, 1.65\u20133.48)). The risk of failure in the first screening attempt increased progressively with the number of fibroids (aOR, 5.05 (95%\u2009CI, 2.29\u201311.13) in women with four or more  fibroids) and total fibroid volume, with greater than a 5\u2010fold and 14\u2010fold increase in risk among women with fibroid volumes of 100.1\u2013400\u2009mL (aOR, 5.52 (95%\u2009CI, 2.30\u201313.25)) and &gt;\u2009400\u2009mL (aOR, 14.80 (95%\u2009CI, 4.50\u201348.69)), respectively. Although test failure was more common with chromosome\u2010selective than genome\u2010wide screening, fibroids similarly increased the risk of failure of both screening platforms. Compared to pregnancies without fibroids, those with fibroids had a fetal fraction on average  0.61% lower (adjusted mean difference, \u22120.61% (95%\u2009CI, \u22120.77% to \u22120.45%)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Uterine fibroids are associated with lower fetal fraction and an increased risk of cfDNA screening failure. The strength of this association increases with increasing fibroid number and volume. \u00a9 2024 The Author(s). <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.29098","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T13:01:25Z","timestamp":1724418085000},"page":"463-469","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Uterine fibroids and non\u2010informative cell\u2010free <scp>DNA<\/scp> screening results"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2263-3592","authenticated-orcid":false,"given":"D. L.","family":"Rolnik","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Clinical Sciences Monash University  Melbourne Australia"},{"name":"Women's and Newborn Program Monash Health  Melbourne Australia"},{"name":"Monash Ultrasound for Women  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Raymond","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Clinical Sciences Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Lee","sequence":"additional","affiliation":[{"name":"Women's and Newborn Program Monash Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3068-1700","authenticated-orcid":false,"given":"J.","family":"Ramkrishna","sequence":"additional","affiliation":[{"name":"Women's and Newborn Program Monash Health  Melbourne Australia"},{"name":"Monash Ultrasound for Women  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0765-7780","authenticated-orcid":false,"given":"F.","family":"da Silva Costa","sequence":"additional","affiliation":[{"name":"Maternal Foetal Medicine Unit Gold Coast University Hospital and School of Medicine and Dentistry, Griffith University  Gold Coast Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Menezes","sequence":"additional","affiliation":[{"name":"Monash Ultrasound for Women  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Meagher","sequence":"additional","affiliation":[{"name":"Monash Ultrasound for Women  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17484"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17386"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2022.100844"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.08.034"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6233"},{"key":"e_1_2_8_7_1","unstructured":"Food and Drug Administration (FDA).Genetic Non\u2010Invasive Prenatal Screening Tests May Have False Results: FDA Safety Communication. 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