Second tier non-invasive prenatal testing in a regional prenatal diagnosis service unit: a retrospective analysis and literature review.

Autor:	Ng VKS; Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Yaumatei, Hong Kong., Chan AL; Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Yaumatei, Hong Kong.; Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, United States., Lau WL; Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Yaumatei, Hong Kong., Leung WC; Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Yaumatei, Hong Kong.
Jazyk:	angličtina
Zdroj:	Hong Kong medical journal = Xianggang yi xue za zhi [Hong Kong Med J] 2020 Feb; Vol. 26 (1), pp. 10-18. Date of Electronic Publication: 2020 Jan 22.
DOI:	10.12809/hkmj198197
Abstrakt:	Introduction: The Hong Kong Hospital Authority has newly introduced a new Down's syndrome screening algorithm that offers free-of-charge non-invasive prenatal testing (NIPT) to women who screen as high risk. In preparation for this public-funded second tier NIPT service, the present study was conducted to retrospectively analyse women eligible for NIPT and to review the local literature. Methods: Our retrospective study included women screened as high risk for Down's syndrome (adjusted term risk ≥1:250) during the period of 1 January 2015 to 31 December 2016. We performed descriptive statistics and multivariable logistic regression to examine the factors associated with women's choice between NIPT and invasive testing. We also reviewed existing local literature about second tier NIPT. Results: The study included 525 women who screened positive: 67% chose NIPT; 31% chose invasive diagnostic tests; and 2% declined further testing. Our literature review showed that in non-research (self-financed NIPT) settings, NIPT uptake rates have been increasing since 2011. Nulliparity, first trimester status, higher education, maternal employment, and conception by assisted reproductive technology are common factors associated with self-financed NIPT after positive screening. Among women choosing NIPT, the rates of abnormal results have typically been around 8% in studies performed in Hong Kong. Conclusion: Implementation of second tier NIPT in the public setting is believed to be able to improve quality of care. We expect that the public in Hong Kong will welcome the new policy. Competing Interests: The authors have no conflicts of interest or declarations to report regarding the present work.
Databáze:	MEDLINE
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