# Progress, clinical application and challenges of non-invasive prenatal testing for monogenic diseases

**Authors:** Chengcheng Wang, Dongxia Hou, Gang Wang, Xi Wu, Zhiyong Zhou, Lina Yang, Ying Liu, Xiaohua Wang

PMC · DOI: 10.3389/fped.2026.1734842 · Frontiers in Pediatrics · 2026-02-04

## TL;DR

This review discusses the progress, uses, and challenges of non-invasive prenatal testing for inherited diseases.

## Contribution

The paper provides a systematic summary of current technologies, clinical applications, and challenges in monogenic NIPT.

## Key findings

- Monogenic NIPT faces low sensitivity for maternally inherited variants and limited fetal DNA fraction.
- High cost and lack of standardized validation hinder clinical adoption of monogenic NIPT.
- Ethical and counseling challenges remain significant barriers to widespread implementation.

## Abstract

Monogenic diseases represent a significant healthcare challenge, characterized by their heritable nature and substantial disease burden. While non-invasive prenatal testing (NIPT) is well-established for aneuploidy, its application has rapidly expanded to monogenic conditions. However, current monogenic NIPT faces challenges including low sensitivity for maternally inherited variants, limited fetal DNA fraction, high cost, lack of standardized clinical validation, and complex ethical and counseling considerations. This review systematically summarizes the major technological approaches, current clinical applications, and core challenges of NIPT for monogenic diseases. It further discusses the underlying scientific issues and translational barriers associated with existing technical limitations, and offers perspectives on future directions. The aim is to provide a reference framework for advancing research and promoting standardized clinical implementation in this field.

## Full-text entities

- **Genes:** RHD (Rh blood group D antigen) [NCBI Gene 6007] {aka CD240D, DIIIc, HDFNRH, RH, RH30, RHCED}, FGFR3 (fibroblast growth factor receptor 3) [NCBI Gene 2261] {aka ACH, CD333, CEK2, HSFGFR3EX, JTK4}, KMT2D (lysine methyltransferase 2D) [NCBI Gene 8085] {aka AAD10, ALR, BCAHH, CAGL114, KABUK1, KMS}, PAH (phenylalanine hydroxylase) [NCBI Gene 5053] {aka PH, PKU, PKU1}, FMR1 (fragile X messenger ribonucleoprotein 1) [NCBI Gene 2332] {aka FMRP, FRAXA, POF, POF1}, CYP21A2 (cytochrome P450 family 21 subfamily A member 2) [NCBI Gene 1589] {aka CA21H, CAH1, CPS1, CYP21, CYP21B, P450c21B}, COL1A1 (collagen type I alpha 1 chain) [NCBI Gene 1277] {aka CAFYD, EDSARTH1, EDSC, OI1, OI2, OI3}
- **Diseases:** structural anomalies (MESH:C536503), fetal (MESH:D005315), RHDO (MESH:C535601), thalassemia (MESH:D013789), inherited hearing loss (MESH:D034381), neural tube defects (MESH:D009436), autosomal dominant disorders (MESH:D030342), Monogenic diseases (MESH:D004194), recessive conditions (MESH:D020763), anomalies (MESH:D000013), autosomal dominant condition (MESH:C566739), anxiety (MESH:D001007), congenital disabilities (OMIM:617404), monogenic kidney diseases (MESH:D007674), PKU (MESH:D010661), aneuploidy (MESH:D000782), Fanconi anemia (MESH:D005199), achondroplasia (MESH:D000130), X-linked conditions (MESH:C536424), rare (MESH:D035583), premature death (MESH:D003643), Kabuki syndrome (MESH:C537705)
- **Chemicals:** silica (MESH:D012822)
- **Mutations:** c.1138G > A

## Full text

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## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12913514/full.md

## References

60 references — full list in the complete paper: https://tomesphere.com/paper/PMC12913514/full.md

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Source: https://tomesphere.com/paper/PMC12913514