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CC BY-NC-ND 4.0 · AJP Rep 2021; 11(01): e38-e48
DOI: 10.1055/s-0040-1721674
Case Report

Association between Levels of Total Cell-Free DNA and Development of Preeclampsia—A Literature Review

Yi Wu
1   OMNI Research Group, Ottawa Hospital Research Institute, Ottawa, Canada
2   Department of Prenatal Diagnosis Centre, Shanghai JiaoTong University, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai, China
3   OHRI, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
,
Ana Werlang 
4   Division of Maternal–Fetal Medicine, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Canada
,
Weiwei Cheng
5   Department of Obstetrics, Shanghai JiaoTong University, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai, China
,
Andrea Lanes
6   Better Outcomes and Registry Network, Ottawa, Canada
7   CHEO, Children's Hospital of Eastern Ontario, Ottawa, Canada
,
Shi Wu Wen
8   Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
,
Mark Walker
3   OHRI, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
4   Division of Maternal–Fetal Medicine, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Canada
9   Canadian Institutes of Health Research, Ottawa, Canada
› Author Affiliations Funding This study was supported by CIHR (Canadian Institutes of Health Research), Grant Number FDN-148438.
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Abstract

Objectives The aim of the study is to synthesize the evidence and evaluate the total cell-free deoxyribonucleic (cfDNA) associated with the prediction of preeclampsia (PE). Total cfDNA is constituted by both cell-free fetal DNA (cffDNA) originated mainly from the placenta, and maternal cfDNA derived from maternal leukocytes.

Methods A systematic review was conducted by searching PubMed and Medline. Literature reporting levels of total cfDNA in the development of PE was included. Studies that only reported cffDNA, but no cfDNA concentrations were not included in this review.

Results Eight studies were included. Seven reported values of cfDNA in PE patients, regardless of early or late onset PE, six of which demonstrated a significant increase of cfDNA in patients who subsequently developed PE. Seven studies evaluated cfDNA levels in the first trimester, six of which showed significant increase of cfDNA concentrations in women who later developed PE. Five studies investigated cfDNA levels in the second trimester, all presenting increased total cfDNA levels in the PE group compared with normal controls.

Conclusion Total cfDNA may play a role as a biochemical marker of PE, compared with fetal cfDNA. Large prospective studies with homogeneous populations and standardized methodology are needed to further confirm its predictive value.

Keywords

cell-free DNA - preeclampsia - cfDNA - pregnancy

Author's Contributions

Y.W. and A.W. contributed equally for the development of this paper and should be considered first authors. Y.W., A.L., and M.W. developed the research question and protocol for this study. Y.W. wrote the first draft and extracted the data. A.W. critically reviewed, rewrote, and revised the manuscript. Y.W., A.W., and M.W. have primary responsibility for the final content. All authors provided feedback on the read and approved the final manuscript.




Publication History

Received: 12 December 2018

Accepted: 24 April 2020

Article published online:
16 March 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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