Accepting or declining the offer of prenatal screening for congenital defects: test uptake and women's reasons

Berg, Matthijs van den; Timmermans, Daniëlle R. M.; Kleinveld, Johanna H.; García, Elisa; Vugt, J.M.G. van; Wal, Gerrit van der

doi:10.1002/pd.1090

Cited by 99 publications

(87 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In The Netherlands, these aspects have indeed been shown to be reasons for declining prenatal screening. 6,21 Participants were therefore very positive about NIPT, as they thought that the characteristics of the test, that is, the increased accuracy, reduced chance of requiring follow-up testing and earlier performance could diminish the disadvantages of prenatal screening and thus lower the barrier for participation. These findings are in line with other studies where positive attitudes and high interest in NIPT were found among pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…Greely 5 , for example, provides a summary of the ethical questions that have been raised with regard to the implications of NIPT on the current prenatal screening setting and even on society as a whole. 5 Where many women now decline prenatal screening due to the miscarriage risk of follow-up diagnostic testing, 6 it is likely that more women will consider NIPT as it does not jeopardise the health of their foetus. Ethicists, however, worry that the safety and ease of the test might lead to normalisation of testing (trivial to offer and take) and to a decrease in informed choice, as parents might not be aware or fully comprehend what they are consenting to.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Attitudes of pregnant women and male partners towards non-invasive prenatal testing and widening the scope of prenatal screening

et al. 2014

View full text Add to dashboard Cite

Non-invasive prenatal testing (NIPT) and its potential to test for multiple disorders has received much attention. This study explores attitudes of women and men towards NIPT, and their views on widening the scope of prenatal testing in a country with a low uptake of prenatal screening (The Netherlands). Five focus groups with low-risk pregnant women (n ¼ 28), three focus groups with men (n ¼ 19) and 13 interviews with high-and low-risk pregnant women were conducted. Participants felt that current prenatal screening has great disadvantages such as uncertain results and risk of miscarriage from follow-up diagnostics. Characteristics of NIPT (accurate, safe and early testing) could therefore diminish these disadvantages of prenatal screening and help lower the barrier for participation. This suggests that NIPT might allow couples to decide about prenatal testing based mostly on their will to test or not, rather than largely based on fear of miscarriage risk or the uncertainty of results. The lower barrier for participation was also seen as a downside that could lead to uncritical use or pressure to test. Widening the scope of prenatal testing was seen as beneficial for severe disorders, although it was perceived difficult to determine where to draw the line. Participants argued that there should be a limit to the scope of NIPT, avoiding testing for minor abnormalities. The findings suggest that NIPT could enable more meaningful decision-making for prenatal screening. However, to ensure voluntary participation, especially when testing for multiple disorders, safeguards on the basis of informed decision-making will be of utmost importance. INTRODUCTIONNon-invasive prenatal testing (NIPT) allows detection of chromosomal aneuploidies in the foetus by using circulating cell-free foetal DNA (cffDNA) in the plasma of pregnant women. 1 This technique makes it possible to detect foetal trisomies 21, 13 and 18 as early as 9 weeks into the pregnancy, and perhaps even earlier. 2 As the procedure of NIPT consists of only drawing a blood sample, it eliminates the risk of miscarriage associated with invasive diagnostic procedures, that is, chorionic villus sampling (CVS) and amniocentesis. Consequently, NIPT assures both earlier and safer prenatal testing, although diagnostic confirmation of abnormal NIPT results by invasive testing is still required due to the chance of false positive test results. 3 In 2010, Lo et al 4 showed that it is possible to deduce the entire genomic sequence of a foetus through NIPT, implying that NIPT could identify a much wider range of genetic disorders in the future. These major developments in the field of prenatal testing are generating a great amount of debate regarding the potential impact, benefits and drawbacks of NIPT. Greely 5 , for example, provides a summary of the ethical questions that have been raised with regard to the implications of NIPT on the current prenatal screening setting and

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Attitudes of pregnant women and male partners towards non-invasive prenatal testing and widening the scope of prenatal screening

et al. 2014

View full text Add to dashboard Cite

show abstract

“…32,33 Another explanation might be that these participants were of the opinion that the screening test was not good enough, as research has shown that many women give this reason ("unfavorable test characteristics") for declining prenatal screening. 34 On the other hand, value inconsistency due to accepting prenatal screening while being negative about it might be attributed to social pressure or normalization of prenatal screening. Further research is needed to investigate the real causes behind value inconsistency.…”

Section: Discussionmentioning

confidence: 99%

Are pregnant women making informed choices about prenatal screening?

Berg

Timmermans

Kate

et al. 2005

Genetics in Medicine

Self Cite

168

141

View full text Add to dashboard Cite

Purpose: Prenatal screening should enable pregnant women to make informed choices. An informed decision is defined as being based on sufficient, relevant information and consistent with the decision maker's values. This study aims to assess to what extent pregnant women make informed choices about prenatal screening, and to assess the psychological effects of informed decision-making. Methods: The study sample consisted of 1159 pregnant women who were offered the nuchal translucency measurement or the maternal serum screening test.Level of knowledge, value consistency, informed choice, decisional conflict, satisfaction with decision, and anxiety were measured using questionnaires. Results: Of the participants, 83% were classified as having sufficient knowledge about prenatal screening, 82% made a value-consistent decision to accept or decline prenatal screening, and 68% made an informed decision. Informed choice was associated with more satisfaction with the decision, less decisional conflict (this applied only to test acceptors), but was not associated with less anxiety. Conclusion:Although the rate of informed choice is relatively high, substantial percentages of women making uninformed choices due to insufficient knowledge, value inconsistency, or both, were found. Informed choice appeared to be psychologically beneficial. The present study underlines the importance of achieving informed choice in the context of prenatal screening. Genet Med 2005:7(5):332-338.

show abstract

“…7 Sadece hastaların %5,8'i (n=18) inancım nedeniyle test yaptırmak istemiyorum şeklinde cevap vermiştir. Bu grubun tamamı ikili ve üçlü tarama testleri için bu cevabı vermiştir.…”

Section: 5unclassified

Gebe Kadınların Antenatal Testlere Yaklaşımını Etkileyen Faktörler

Desdicioğlu¹,

Yıldırım²,

Suleymanova³

et al. 2017

Ankara Medical Journal

View full text Add to dashboard Cite

ÖzAmaç: Antenatal bakım ve tarama testlerinin anne ve bebeğin mortalitesini azalttığı bilinmektedir. Çalışmamızda antenatal tarama testlerini yaptırmak konusunda hastaları en çok etkileyen faktörleri tespit etmeyi amaçladık. Medyanın gebe kadınların antenatal tarama testlerine yaklaşımına etkilerini değerlendirmeyi planladık. Materyal ve Metot: Gebe polikliniğine 30 günlük süre içinde başvuran 310 gebenin gebelikteki tarama testlerine yaklaşımları çeşitli sorularla değerlendirilmiştir. Bulgular: Gebelerin kadın hastalıkları ve doğum uzmanının yanı sıra aile hekimlerine rutin takip olmaları bilgilenme düzeylerine olumlu katkıda bulunmaktadır. Özellikle diyabet tarama testini yaptırmak istemeyen gebelerin çoğunlukla medyatik açıklamalardan etkilendiği tespit edilmiştir. Sonuç: Antenatal tarama testleri ile ilgili bilgilendirme yapma konusunda gebeyi ilk muayene eden hekime büyük görev düşmektedir. Hastaların testlere yaklaşımını olumsuz etkileyen faktörlerden en sık olanı olan medyatik açıklamaların kontrollü yapılabilmesi için de gerekli düzenlemeler yapılmalıdır. Anahtar kelimeler: Antenatal tarama testleri, gebelikte diyabet tarama testi, medya etkisi Abstract Objectives: Prenatal screening tests reduce the maternal and perinatal mortality as known. In our study, we aimed to investigate which factors affect the pregnant women most on how to take antenatal screening tests. We planned to evaluate the effects of media on pregnant women's approach to antenatal screening tests. Materials and methods: 310 pregnant women who were admitted to the pregnancy outpatient clinic within 30 days have been evaluated by a variety of questions. Results: Follow ups of pregnant women by their gynecologists and family doctors increase the level of knowledge for screening tests. Particularly the pregnant women who do not want to take the diabetes screening test have been mostly affected by the media. Conclusion: Clinicians who examine to pregnant women firstly have a great duty to inform about them antenatal screening tests. We need to make arrangements on mediatic explanations that affect the pregnant women negatively about screening tests.

show abstract

Accepting or declining the offer of prenatal screening for congenital defects: test uptake and women's reasons

Cited by 99 publications

References 34 publications

Attitudes of pregnant women and male partners towards non-invasive prenatal testing and widening the scope of prenatal screening

Attitudes of pregnant women and male partners towards non-invasive prenatal testing and widening the scope of prenatal screening

Are pregnant women making informed choices about prenatal screening?

Gebe Kadınların Antenatal Testlere Yaklaşımını Etkileyen Faktörler

Contact Info

Product

Resources

About