Multicentric Longitudinal Performance Monitoring of Different Prenatal Cell‐Free DNA Screening Technologies in Belgium

OBJECTIVE: Prenatal cell-free DNA screening is widely used to assess the risk of fetal trisomy 21, 18, and 13. Although commercial and laboratory-developed tests (LDTs) show high accuracy in validation studies, real-world longitudinal performance data are lacking. METHOD: In Belgium, prenatal cell-free DNA screening is a population screening offered to all pregnant people, regardless of their a priori risk. Over 3 years, all confirmatory diagnostic tests after a positive prenatal cell-free DNA screening result were recorded along with the technologies used and their outcomes. Positive predictive values (PPVs) for the three common fetal trisomies were calculated per technology. RESULTS: A total of 1158 diagnostic tests were performed after a positive prenatal cell-free DNA screening. Of these, 58.5% came from an LDT, 15.7% from VeriSeq (Illumina), 6.6% from Harmony (Roche), 5% from Vanadis (Perkin-Elmer); for 14.2% the technology could not be traced. PPVs ranged from 92.2% to 65.7% for trisomy 21, from 82.8% to 44.4% for trisomy 18, and from 40% to 18.2% for trisomy 13. Overall, the LDT performed better than the commercial tests. CONCLUSION: This study confirms the reported accuracy of commercial tests and LDT, while showing that LDT generally outperforms commercial tests. Despite high specificities across tests, differences in PPVs significantly impact pregnant people and the national health care system.

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Publication Details

Journal
Prenatal Diagnosis
Published
2026-08-17
DOI
https://doi.org/10.1002/pd.70236
Primary Topic
Prenatal Screening and Diagnostics
Type
article
Field-Weighted Citation Impact
0.00

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article

Multicentric Longitudinal Performance Monitoring of Different Prenatal Cell‐Free DNA Screening Technologies in Belgium

Kim Van Berkel, Machteld Baetens, Marie Bruneau, Ann Van Den Bogaert et al.
Prenatal Diagnosis
Prenatal Screening and Diagnostics
article

Multicentric Longitudinal Performance Monitoring of Different Prenatal Cell‐Free DNA Screening Technologies in Belgium

Kim Van Berkel, Machteld Baetens, Marie Bruneau, Ann Van Den Bogaert, Armelle Duquenne, Jean‐Stéphane Gatot, Leen Vancoillie, Katrien Janssens, Olivier Vanakker, Bettina Blaumeiser, Bruno Pichon, Angelica Pagliazzi, Axel Marichal, Isabelle Vandernoot, Lore Lannoo, Marjan De Rademaeker, Björn Menten, Sandra Coppens, Sandra Janssens, Ilse Parijs, S. Rombout, Colombine Meunier, Koenraad Devriendt, Ileen Slegers, Nathalie Brison, Yves Sznajer, Annelies Fieuw, Julie Désir, Saskia Bulk, Kris Van Den Bogaert, Mauricette Jamar, Joris R. Vermeesch, Bert Callewaert, Anne De Leener, Michelle DEBERG
article en

Abstract

OBJECTIVE: Prenatal cell-free DNA screening is widely used to assess the risk of fetal trisomy 21, 18, and 13. Although commercial and laboratory-developed tests (LDTs) show high accuracy in validation studies, real-world longitudinal performance data are lacking. METHOD: In Belgium, prenatal cell-free DNA screening is a population screening offered to all pregnant people, regardless of their a priori risk. Over 3 years, all confirmatory diagnostic tests after a positive prenatal cell-free DNA screening result were recorded along with the technologies used and their outcomes. Positive predictive values (PPVs) for the three common fetal trisomies were calculated per technology. RESULTS: A total of 1158 diagnostic tests were performed after a positive prenatal cell-free DNA screening. Of these, 58.5% came from an LDT, 15.7% from VeriSeq (Illumina), 6.6% from Harmony (Roche), 5% from Vanadis (Perkin-Elmer); for 14.2% the technology could not be traced. PPVs ranged from 92.2% to 65.7% for trisomy 21, from 82.8% to 44.4% for trisomy 18, and from 40% to 18.2% for trisomy 13. Overall, the LDT performed better than the commercial tests. CONCLUSION: This study confirms the reported accuracy of commercial tests and LDT, while showing that LDT generally outperforms commercial tests. Despite high specificities across tests, differences in PPVs significantly impact pregnant people and the national health care system.

Prenatal Diagnosis
Cliniques Universitaires Saint-Luc (BE), University of Liège (BE), Ghent University Hospital (BE), Erasmus Hospital (BE), Institute of Pathology and Genetics (BE), Antwerp University Hospital (BE), Center for Human Genetics (US), Centre Hospitalier Universitaire de Liège (BE)
KU Leuven
Openalex Percentile: Top 6%
Prenatal Screening and Diagnostics
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