Taipei City Hospital (Taiwan)

Central hypersomnia disorder (CHD) may result in a higher risk of injury/accident. The present study aims to investigate the real‐world risk by tracing patients in a clinical cohort for 4 years. We tracked the injury/accident risk of CHD clinical cohort patients from Taiwan's National Health Insurance Research Database (NHIRD) and compared it with controls. Data were collected based on the International Classification of Diseases, Tenth Revision. Patients were categorised by diagnosis, gender and age, with each subgroup compared to age‐ and gender‐matched controls. Group differences were analysed using the Chi‐square test and t ‐test. Bonferroni correction was used for post hoc analysis. A total of 386 CHD clinical cohort patients were included. Narcolepsy type 1 patients had the highest subjective and objective symptom severity ( p  < 0.001). Compared to controls, CHD patients had a significantly higher risk of injury and accident of up to 61.92% and 7.51% during the 4‐year follow‐up, necessitating clinical visits. Narcolepsy type 2 patients have the highest risk of injury ( p  = 0.005). Age/gender differences were found. Males had a higher specific‐site injury risk ( p  = 0.045) than females, while females had a higher transportation accident risk than controls ( p  = 0.048). Children/adolescents had a higher risk in total injury and multiple‐site injury than controls ( p  = 0.024, p  = 0.014), and adults had a higher risk in specific‐site injury and transportation accident ( p  = 0.020, p  = 0.004). In conclusion, CHD patients had a higher risk of injury/accident, even among those with milder symptoms. Gender and age differences in these risks were observed. Our findings highlight the importance of hypersomnia treatment and individualised considerations in clinical practice.

The non-invasive prenatal testing (NIPT) and preeclampsia screening test (PES) has been widely used to detect fetal chromosomal abnormalities and maternal preeclampsia during early pregnancy. Our aim was to investigate the correlation between PES parameters and NIPT aneuploidy results.

We retrospectively analyzed pregnancies that underwent both PES and NIPT. PES included multiples of the median (MoM) of PlGF, PAPP-A, MAP, and calculated risks for preeclampsia, intrauterine growth restriction (IUGR), and preterm delivery, while NIPT assessed risks for common aneuploidies, rare autosomal abnormalities, and fetal fraction. Statistical correlation analyses were conducted to evaluate associations between the parameters of the two tests.

Lower PlGF MoM and PAPP-A MoM were significantly associated with high-risk NIPT for Down and Edwards syndromes. Specific PlGF MoM cut-offs (<0.5315, <0.8515) showed higher probabilities of high-risk NIPT for Down and Edwards syndromes (AUC 0.829 and AUC 0.836, respectively). Similarly, PAPP-A MoM cut-offs (<0.7335, <0.429) indicated higher probabilities of high-risk NIPT for Down and Edwards syndromes (AUC 0.765 and AUC 0.909, respectively). High-risk PES for preeclampsia increased the odds of high-risk NIPT for Down and Edwards syndromes by 3.54 and 2.33 times, respectively; for IUGR, the increases were 8.38 and 12.25 times. High-risk PES for preterm delivery was associated with a 1.09-fold increase in the odds of high-risk NIPT for rare autosomal abnormalities. Fetal fraction was significantly lower in high-risk PES cases, positively correlated with PlGF MoM and PAPP-A MoM, and negatively with MAP MoM.

Fetal chromosomal abnormalities may indicate increased risk for PES parameters and risk assessments. Reduced NIPT fetal fraction in high-risk PES suggests potential placental dysfunction. Combining PES parameters and NIPT fetal fraction may provide reference for prenatal risk assessment.