Does non‐invasive prenatal testing affect the livebirth prevalence of Down syndrome in the Netherlands? A population‐based register study

Abstract

Objective: To evaluate if non-invasive prenatal testing (NIPT) affects livebirth (LB) prevalence of Down syndrome (DS) in the Netherlands.

A cross‐country comparison of pregnant women's decision‐making and perspectives when opting for non‐invasive prenatal testing in the Netherlands and Belgium

“…Dutch respondents less often intended to terminate the pregnancy in case of trisomy 21. Research showed only a minimal effect of the introduction of NIPT in the Netherlands on the trend in the live birth prevalence of trisomy 21 36 . In Belgium, a small decline in live births with trisomy 21 was observed since the introduction of NIPT, but this could also be explained by a decline in false‐negative results compared to FTCS 15 .…”

“…Research showed only a minimal effect of the introduction of NIPT in the Netherlands on the trend in the live birth prevalence of trisomy 21. 36 In Belgium, a small decline in live births with trisomy 21 was observed since the introduction of NIPT, but this could also be explained by a decline in false-negative results compared to FTCS. 15 Sociocultural values, attitudes toward disability and termination of pregnancy as well as the legal aspects toward termination of pregnancy may partly explain the use of NIPT, which varies widely between countries.…”

Non‐invasive prenatal testing for everybody or contingent screening?

“…A register study by de Groot‐van der Mooren et al. (2021) in the period 2014–2018 concluded that the decreasing livebirth prevalence of Down syndrome was not affected by the introduction of first‐tier NIPT 30 . The authors argued that the gradual decrease in the livebirth prevalence of Down syndrome most likely resulted from a broader development of more prenatal testing that had started before the introduction of NIPT.…”

Non‐invasive prenatal testing 10 years on

“…28 In this issue, colleagues from the Netherlands publish data from their national registry following the introduction of a national NIPT screening programme, and show that there was an already decreasing trend in the prevalence of live births with DS which has not been affected by the implementation of the NIPT screening programme. 29 In summary, in this special issue, we show how NIPT has evolved from screening for trisomies offered largely through the commercial sector in high-risk pregnancies, to a highly efficient screening test offered in both private and public healthcare systems to all-risk pregnancies. We describe the increasing indications, debates and challenges, both practical and ethical.…”

“…Data published previously, largely from research cohorts, have implied that there will not be a significant impact as the high uptake of NIPT is in part due to women taking the safer test for information only 28 . In this issue, colleagues from the Netherlands publish data from their national registry following the introduction of a national NIPT screening programme, and show that there was an already decreasing trend in the prevalence of live births with DS which has not been affected by the implementation of the NIPT screening programme 29 …”