Screening of Placental Dysfunction Utilizing Cell-Free Nucleic Acids (cfNAs) of Maternal Plasma

Disturbances in placental development can lead to dysfunction or insufficiency. Placental biomarkers traditionally used for chromosomal abnormality screening, such as human chorionic gonadotropin, progesterone, and vascular endothelial growth factor, are now being explored for studying placental dysfunction. The release of nucleic acids and protein fragments into maternal circulation due to trophoblast cell apoptosis or necrosis allows for the quantification of cell-free nucleic acids (cfNAs) via genomic methods with high sensitivity. Elevated cfNA levels, notably in preeclampsia, precede clinical symptoms, suggesting its potential as a predictive biomarker. However, large prospective studies are necessary to validate these biomarkers and identify a universal marker for predicting adverse perinatal outcomes related to placental dysfunction. This chapter reviews literature on the role of NIPS in identifying pregnancies at risk of placental dysfunction.