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Prenat Diagn. 2016 Dec;36(12):1091-1098. doi: 10.1002/pd.4941. Epub 2016 Nov 16.

Trial by Dutch laboratories for evaluation of non-invasive prenatal testing. Part II-women's perspectives.

Author information

1
Department of Clinical Genetics, Section Community Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
2
Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht, The Netherlands.
3
Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands.
4
Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
5
Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
6
Department of Obstetrics and Gynaecology, Maastricht UMC+, Maastricht, The Netherlands.
7
Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
8
Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
9
Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands.
10
Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands.
11
Department of Clinical Genetics, Maastricht UMC+, Maastricht, The Netherlands.
12
Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
13
Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands.

Abstract

OBJECTIVE:

To evaluate preferences and decision-making among high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing.

METHODS:

Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice.

RESULTS:

A total of 1091/1253 (87%) women completed the questionnaire. Of these, 1053 (96.5%) underwent NIPT, 37 (3.4%) invasive testing and 1 (0.1%) declined testing. 91.7% preferred NIPT because of test safety. Overall, 77.9% made an informed choice, 89.8% had sufficient knowledge and 90.5% had positive attitudes towards NIPT. Women with intermediate (odds ratio (OR) = 3.51[1.70-7.22], p < 0.001) or high educational level (OR = 4.36[2.22-8.54], p < 0.001) and women with adequate health literacy (OR = 2.60[1.36-4.95], p = 0.004) were more likely to make an informed choice. Informed choice was associated with less decisional conflict and less anxiety (p < 0.001). Intention to terminate the pregnancy for Down syndrome was higher among women undergoing invasive testing (86.5%) compared to those undergoing NIPT (58.4%) (p < 0.001).

CONCLUSIONS:

The majority of women had sufficient knowledge and made an informed choice. Continuous attention for counseling is required, especially for low-educated and less health-literate women. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.

PMID:
27739584
PMCID:
PMC5213994
DOI:
10.1002/pd.4941
[Indexed for MEDLINE]
Free PMC Article

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