title: Down syndrome and cell-free fetal DNA in archived maternal serum.
abstract: OBJECTIVE
  Increased levels of cell-free fetal DNA (f-DNA) in the maternal circulation are a potential noninvasive marker for fetal Down syndrome. Our objectives were to (1) determine whether f-DNA could be quantified by using archived serum and amniotic fluid, (2) examine whether serum f-DNA levels are elevated in Down syndrome pregnancies in a case-control series matched for gestational age and duration of sample storage, and (3) determine whether f-DNA levels are elevated in the amniotic fluid of Down syndrome fetuses.
  
  
  METHODS
  Eleven serum and six amniotic fluid samples previously collected and stored at -20 degrees C from gravid women carrying a 47,XY,+21 fetus were each paired with five matched control samples of identical specimen type from gravid women carrying a presumed euploid male fetus. f-DNA concentration was quantified blindly by real-time polymerase chain reaction amplification for a Y-chromosome sequence. Matched rank-sum analysis and analysis of variance were used for analysis.
  
  
  RESULTS
  The mean observed rank of 5.0 in the Down syndrome group was significantly higher than expected (P </=.005). Adjusted mean serum f-DNA concentrations were 41.2 genomic equivalents (GE) per milliliter for the Down syndrome cases and 24.2 GE/mL for the euploid controls (P =.002). Differences among amniotic fluid samples were not statistically significant. There was a suggestion of a sample storage effect on f-DNA concentration on the order of -0.66 GE/mL per month (P =.071).
  
  
  CONCLUSIONS
  Down syndrome pregnancies exhibit 1.7-fold higher levels of maternal serum cell-free f-DNA compared with matched controls. No such association is observed in amniotic fluid. Archived serum appears to be a useful source of clinical material for retrospective analyses but may require controlling for the duration of sample storage.
authors.affiliation: Divison of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Brown University, Providence, RI, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lee
authors.forename: Erik S
authors.initials: ES
authors.lastname: LeShane
authors.forename: Geralyn M
authors.initials: GM
authors.lastname: Messerlian
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Canick
authors.forename: Antonio
authors.initials: A
authors.lastname: Farina
authors.forename: Walter W
authors.initials: WW
authors.lastname: Heber
authors.forename: Diana W
authors.initials: DW
authors.lastname: Bianchi
mesh_terms: D000653:Amniotic Fluid / Q000378:metabolism; D001109:Archives; D035061:Control Groups; D004247:DNA / Q000097:blood / Q000378:metabolism*; D004314:Down Syndrome / Q000196:embryology* / Q000235:genetics*; D005260:Female; D005333:Fetus / Q000378:metabolism*; D006801:Humans; D008297:Male; D011247:Pregnancy / Q000097:blood* / Q000378:metabolism; D011309:Preservation, Biological / Q000009:adverse effects
chemical_list: D004247:DNA