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

Autor: van Schendel RV; Department of Clinical Genetics, Section Community Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands., Page-Christiaens GC; Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht, The Netherlands., Beulen L; Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands., Bilardo CM; Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., de Boer MA; Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands., Coumans AB; Department of Obstetrics and Gynaecology, Maastricht UMC+, Maastricht, The Netherlands., Faas BH; Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands., van Langen IM; Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Lichtenbelt KD; Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands., van Maarle MC; Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands., Macville MV; Department of Clinical Genetics, Maastricht UMC+, Maastricht, The Netherlands., Oepkes D; Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Pajkrt E; Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands., Henneman L; Department of Clinical Genetics, Section Community Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Prenatal diagnosis [Prenat Diagn] 2016 Dec; Vol. 36 (12), pp. 1091-1098. Date of Electronic Publication: 2016 Nov 16.
DOI: 10.1002/pd.4941
Abstrakt: 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.
(© 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.)
Databáze: MEDLINE
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