Inferring fetal fractions from read heterozygosity empowers the noninvasive prenatal screening

Purpose Fetal fraction (FF) is the percent of cell-free DNA (cfDNA) in the mother’s peripheral blood that is of fetal origin, which plays a pivotal role in noninvasive prenatal screening (NIPS). We present a method that can reliably estimate FFs by examining autosome single-nucleotide polymorphisms (SNPs). Methods Even at a very low sequencing depth, there are plenty of SNPs covered by more than one read. At those SNPs, we define read heterozygosity and demonstrate that the percent of read heterozygosity is a function of FF, which allows FF to be inferred. Results We first demonstrated the effectiveness of our method in inferring FF. Then we used the inferred FF as an informative alternative prior to computing Bayes factors to test for aneuploidy, and observed better power than the Z-test. In analysis of clinical samples, we were able to identify female–male twins thanks to the accurate FF inference. Conclusion Knowing FF improves efficacy of NIPS. It brings a powerful Bayesian method, allows “no call” for samples with small FFs, renders screening for XXY syndrome simpler, and permits an adaptive design to sequence at a higher depth for samples with small FFs.