Women's uptake of non‐invasive DNA testing following a high‐risk screening test for trisomy 21 within a publicly funded healthcare system: findings from a retrospective review. (4th January 2015)

• Record Type: Journal Article
• Authors: Chan, Yiu Man; Leung, Wing Cheong; Chan, Wan Pang; Leung, Tak Yeung; Cheng, Yvonne Kwun Yue; Sahota, Daljit Singh
• Is Part Of: Prenatal diagnosis. Volume 35:Number 4(2015:Apr.)
• Page Start: 342
• Page End: 347
• Publication Date: 2015-01-04
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4544
• Languages: English
• ISSNs: 0197-3851

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="pd4544-sec-0001" sec-type="section"> <title>Objective</title> <p>The objective of the study was to evaluate the uptake of non‐invasive cell‐free fetal DNA screening test (NIDT) after a high‐risk screening result for trisomy 21</p> </sec> <sec id="pd4544-sec-0002" sec-type="section"> <title>Methods</title> <p>Association between maternal and pregnancy characteristics on women's test choice was assessed after adjusting for confounding factors in Hong Kong Chinese women who had a high‐risk (term risk ≥1:250) first‐trimester or second‐trimester screening test at three public hospitals. Main outcome measures were rate of declining further testing and obstetric and maternal factors impacting on patient's selection of testing options.</p> </sec> <sec id="pd4544-sec-0003" sec-type="section"> <title>Results</title> <p>Compared with the pre‐NIDT period, the availability of NIDT resulted in a 45% (<italic>P</italic> < 0.001) reduction in the rate of refusal for further testing and a decrease from 92.2% to 66.7% in the use of invasive diagnostic test after a positive screening test. Nulliparous women with a spontaneous [adjusted odds ratio (aOR) = 2.18, 95% confidence interval (CI) 1.63–2.92] or assisted reproduction pregnancy (aOR = 3.95, 95% CI 1.6–9.32) were more likely to choose NIDT. Women with an adjusted risk of '>1:10' (aOR = 7.36, 95% CI 4.22–12.8) and '1:10 to 1:50' (aOR = 1.53, 95% CI 1.01–2.32) were more likely to opt for chorionic villi sampling or amniocentesis.</p> </sec> <sec id="pd4544-sec-0004" sec-type="section"> <title>Conclusions</title> <p>NIDT reduced the refusal rate. Uptake of NIDT was highest in pregnancies of nulliparous women. © 2014 John Wiley & Sons, Ltd.</p> </sec> </abstract>