Prenatal Diagnosis and Pregnancy Outcomes of Fetuses With Orofacial Cleft: A Retrospective Cohort Study in Two Centres in Hong Kong

Objective To evaluate the local incidence of orofacial cleft (OFC) encountered in fetal morphology scan and prenatal diagnosis, genetic etiology of fetuses with or without other structural abnormalities, and their pregnancy outcomes. Design Retrospective cohort study. Setting Two maternal fetal medi...

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Bibliographic Details
Published in:The Cleft palate-craniofacial journal 2024-03, Vol.61 (3), p.391-399
Main Authors: Li, Yan Yu, Tse, Wing Ting, Kong, Choi Wah, Wong, Natalie Kwun Long, Leung, Tak Yeung, Choy, Kwong Wai, To, William Wing Kee, Cao, Ye
Format: Article
Language:English
Subjects:
Birth defects
Cohort analysis
Fetuses
Genetic counseling
Pregnancy
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Summary:Objective To evaluate the local incidence of orofacial cleft (OFC) encountered in fetal morphology scan and prenatal diagnosis, genetic etiology of fetuses with or without other structural abnormalities, and their pregnancy outcomes. Design Retrospective cohort study. Setting Two maternal fetal medicine units, tertiary hospitals, Hong Kong. Participants All pregnant women with antenatal diagnosis of fetal OFC between January 2016 and December 2020 (N = 66). Results OFC has an incidence of 0.13% among pregnancies in Hong Kong and 28.8% (19/66) were syndromic cleft that exhibited other fetal structural anomalies. There were 55 cases (84.6%) who opted for invasive prenatal diagnostic testing. Genetic defects were identified in 25.8% (17/66) of this cohort, including 14 pathogenic variants. The detection rate in the syndromic cases is 68.4% (13/19) which was significantly higher than 8.5% (4/47) among non-syndromic cases. Aneuploidies would be the most common cause, accounting for 9.1% (6/66). Chromosomal microarray analysis (CMA) provided an incremental diagnostic yield of 6.1% compared to conventional karyotyping. A total of 29 live births including 3 cases of a variant of uncertain significance and 26 cases without genetic abnormalities detected have continued pregnancy to birth. There were 87.5% (21/24) without detectable pathogenic genetic abnormality reported good long-term outcomes. The chance of OFC fetuses having a good long-term outcome was significantly higher if no genomic variant was detected (P 
ISSN:1055-6656
1545-1569
DOI:10.1177/10556656221128436