An Adelaide-led Science Advances review reappraises where cell-free fetal DNA comes from, how it enters maternal blood and whether it travels attached to extracellular vesicles or other structures. The authors argue that better biology could improve non-invasive prenatal testing.

NIPT is widely used because it is safer than invasive procedures for screening, but low fetal fraction, false results and limited scope still matter. This paper is a research agenda, not a new clinical test.

Experimental validation, whether fetal-fraction improvements reduce inconclusive results, evidence for broader genetic screening and whether pre-eclampsia prediction becomes clinically useful.