Outcomes of 8 Years of Noninvasive Prenatal Testing at Nippon Medical School Hospital

Abstract

Background: Noninvasive prenatal testing (NIPT) is used to screen for fetal chromosomal abnormalities, such as fetal aneuploidy, and has been offered at our hospital since 2013. We analyzed data from our center to determine if NIPT screenees could be given more-accurate information on NIPT outcomes.Methods: This retrospective observational study included 819 pregnant women who requested NIPT at Nippon Medical School Hospital from November 2013 to October 2021. We examined medical records for data on NIPT results and clinical outcomes.Results: Of the 819 women, 764 (93.2%) underwent NIPT, and 55 (6.7%) did not. Of the 764 women who underwent NIPT, 17 received a positive result (2.2%), of whom 2 (11.8%), 4 (23.5%), and 11 (64.7%) received a positive result for trisomy 13, 18, and 21, respectively. The true-positive rates after definitive diagnoses of trisomy 13, 18, and 21 were 1 (50%), 3 (75%), and 11 (100%), respectively. Of the 17 positive results, there were two false-positive results (11.8%) (for trisomy 13 and trisomy 18). Eleven women with fetal aneuploidy terminated their pregnancies, and four cases resulted in intrauterine fetal death.Five neonates with negative NIPT results had congenital disease without chromosomal abnormality.Two patients had indeterminate results from the first blood sampling, possibly because of treatment with unfractionated heparin. The results of repeat testing after heparin cessation were negative. Conclusions:Our results were generally similar to nationwide data for Japan. NIPT providers can provide more detailed and individualized genetic counseling for each situation by understanding their own medical facility's data in detail.

Change in client choice under multiple prenatal genetic testing options including noninvasive prenatal testing (NIPT) after genetic counseling in a Japanese maternity hospital

“…Our results showed that clients who wished to undergo NIPT or combined tests changed their choice or canceled testing after GC. GC is considered to have a significant impact on the choice of prenatal genetic testing 1,7,15 ; however, in Japan, the impact of GC on the choice of prenatal genetic testing has not been significant in clients who wished to undergo NIPT 9,16 . In this study, more couples did not select NIPT after GC, as opposed to a previous study 16 .…”

“…GC is considered to have a significant impact on the choice of prenatal genetic testing 1,7,15 ; however, in Japan, the impact of GC on the choice of prenatal genetic testing has not been significant in clients who wished to undergo NIPT. 9,16 In this study, more couples did not select NIPT after GC, as opposed to a previous study. 16 This is the major difference between the findings of our study and those of previous reports, because in previous studies, clients may have seen at the unfamiliar facilities where NIPT would be conducted without the knowledge and the availability of other options.…”

“…9,16 In this study, more couples did not select NIPT after GC, as opposed to a previous study. 16 This is the major difference between the findings of our study and those of previous reports, because in previous studies, clients may have seen at the unfamiliar facilities where NIPT would be conducted without the knowledge and the availability of other options. Unlike in previous studies where couples had to visit a specialized hospital only for GC, in this study, couples had the convenience of easily receiving GC at their regular hospital.…”