Women's choices for invasive or non‐invasive testing: influence of gestational age and service delivery. (2nd December 2016)

• Record Type: Journal Article
• Authors: Chen, An; Tenhunen, Henni; Torkki, Paulus; Heinonen, Seppo; Lillrank, Paul; Stefanovic, Vedran
• Is Part Of: Prenatal diagnosis. Volume 36:Number 13(2016)
• Page Start: 1217
• Page End: 1224
• Publication Date: 2016-12-02
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4960
• Languages: English
• ISSNs: 0197-3851

Abstract

Abstract: Objective: To investigate the factors influencing women's post‐counseling choices between non‐invasive prenatal testing (NIPT) and invasive prenatal diagnosis in pregnancies with elevated a priori risk of fetal chromosomal abnormalities or after the initial screening. Methods: Data were collected from test choice database at Fetomaternal Medical Center (FMC) at Helsinki University Hospital, Finland. We focused on the women with gestational age less than 15 weeks and who were offered NIPT or invasive procedure (CVS or amniocentesis) after pre‐test counseling. The Chi‐square test, ANOVA test and multinomial logistic regressions were used to explore significant factors affecting women's choice. Results: In 2015, 333 women in our study group participated in prenatal testing, 260 (78.1%) initially chose NIPT, 62 (18.6%) chose CVS and 11 (3.3%) chose amniocentesis. There was a statistically significant difference among these three test groups with regard to gestational age ( p = 0.025), counseling day ( p < 0.001), certain medical indications and serum screening risk score ( p = 0.028). However, multinomial logistic regressions only confirmed the predictive value of gestational age and counseling day on women's choice. Conclusions: Maternal age was not a strong factor affecting women's choice for prenatal further tests. Medical indications and risk scores have less influence than previously thought. Gestational age and service availability were strong factors. © 2016 John Wiley & Sons, Ltd. Abstract : What's already known about this topic? Previous studies on women's choice‐making in prenatal testing have focused on the factors affecting the uptake of a specific test within specific contexts. There is limited knowledge on how high risk pregnant women choose among different tests: NIPT, CVS and amniocentesis, when the testing service is free of charge. What does this study add? We investigate the potential factors affecting women's choice on three prenatal tests within the Finnish public maternal service system. Gestational age and service availability strongly influence women's choice. Testing convenience is very important. In contrast with previous studies, maternal age and medical risk detected by initial screening may have less influence on women's choice.