Screening options for Down syndrome: how women choose in real clinical setting

Lo, Tsz Kin; Lai, F. K.; Leung, Wing Cheong; Lau, Wai Lam; Ng, Lisa Stella; Wong, WC; Tam, Seline; Yee, Y. C.; Choi, Hye-Mi; Lam, Helena; Sham, Alice; Tang, L.; Chin, Robert

doi:10.1002/pd.2292

Cited by 12 publications

(12 citation statements)

References 19 publications

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“…This result was consistent with the findings of a previous study that nulliparous women were more willing to pay for noninvasive screening testing with less false-positive rates [14]. However, this result was not consistent with a study conducted during the pre-NIPT era [20] in which choosing an invasive test was apparently not associated with parity.…”

Section: Discussionsupporting

confidence: 57%

“…Additionally, there was an increase in uptake of NIPT in year 2, probably because of a fall in price of NIPT during the 2-year period and an increased awareness of the test due to publicity. Women showed willingness to pay for a test with a lower false-positive rate [14]. Women can accept NIPT as an alternative to invasive diagnostic test if the former's accuracy is high (>95%), though lower than the latter in the diagnosis of Down syndrome [15], and can wait longer for test results [16].…”

Section: Discussionmentioning

confidence: 99%

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Uptake of Noninvasive Prenatal Testing in Chinese Women following Positive Down Syndrome Screening

Poon¹,

Tse²,

Kou³

et al. 2014

Fetal Diagn Ther

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Objectives: To investigate how the introduction of noninvasive prenatal testing (NIPT) influenced women's testing choices following a positive Down syndrome screening. Methods: A retrospective study was conducted to compare differences in the uptake rates of invasive prenatal diagnosis (IPD) or no testing in one public hospital 1 year before (pre-NIPT) and 1 and 2 years after the introduction of NIPT in private in August 2011 using descriptive analysis and a χ² test. Conventional screening was funded publicly, but NIPT was not. Multivariable binary logistic regression was used to determine factors affecting choices. Results: In pre-NIPT and in years 1 and 2 after the introduction of NIPT, 306, 362 and 401 women who screened positive were seen, respectively. In year 1 and year 2, 12.6 and 26.7% of them underwent NIPT while IPD was decreased by 16.3 and 25.6%, respectively (p < 0.001). Both chorionic villus sampling and amniocentesis decreased in year 1, but only the former in year 2. However, the rate of declining further testing was similar before and after NIPT (p = 0.213). In multivariable analysis, first trimester screening, nulliparity and working women were significant predictors of accepting NIPT, while only nulliparity was a predictor of declining IPD (OR = 0.61). Conclusions: Introduction of NIPT resulted in a significant decrease in IPD for 2 consecutive years.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Uptake of Noninvasive Prenatal Testing in Chinese Women following Positive Down Syndrome Screening

Poon¹,

Tse²,

Kou³

et al. 2014

Fetal Diagn Ther

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“…Although recognizing that there are technical aspects of NIPD that require refinement, 15,16 we assumed an extremely high sensitivity and specificity, and applicability to all women. We also assumed that although free fetal DNA is present in maternal serum as early as 7 weeks gestation, 17 the test would be offered at a more realistic 12 weeks gestation to coincide with the gestation at which 1TCS and chorionic villous sampling (CVS) are offered.…”

Section: Nipdmentioning

confidence: 99%

Using population-based data to predict the impact of introducing noninvasive prenatal diagnosis for Down syndrome

Susman

Amor

Muggli

et al. 2010

Genetics in Medicine

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“…The available literature has mainly focused on the attitudes of the general public in first-world countries towards PND and TAP (Julian-Reynier et al 1993;Lo et al 2009). Furthermore, few studies have centred on the views of parents with a child with DS regarding these options (Elkins et al 1986;Bryant et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Prenatal diagnosis and termination of pregnancy: perspectives of South African parents of children with Down syndrome

2012

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This study aims to evaluate the attitudes of a group of South African parents with a preschool child with Down syndrome (DS) towards prenatal diagnosis (PND) and termination of a Down syndrome-affected pregnancy (TAP). This study employs a qualitative phenomenological approach with the use of semi-structured interviews. Twelve participants were recruited from two state sector hospitals in Cape Town, South Africa. Thematic analysis was used to interpret the data. The participants had a positive attitude towards PND and felt that it was every parent's right to have the option. They considered a benefit of PND the fact that it allowed parents time to prepare for the arrival of a baby with DS. The induced miscarriage risk associated with invasive prenatal testing procedures caused major negative feelings. They were totally opposed to the termination of a Down syndrome-affected pregnancy due to their personal experience, moral, ethical or religious convictions. South African parents of preschool children with Down syndrome are comfortable with PND for Down syndrome; however, they do not support TAP. These findings will provide health care providers with further insight into the motivations behind the decisions their patients make.

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Screening options for Down syndrome: how women choose in real clinical setting

Abstract: Among older women of predominantly Chinese ethnicity, integrated test is a favorite alternative to FTS. Their choice of DS screening test can be predicted by their obstetric and socioeconomic characteristics. Many women show willingness to pay for a test with a lower false-positive rate.

Cited by 12 publications

References 19 publications

Uptake of Noninvasive Prenatal Testing in Chinese Women following Positive Down Syndrome Screening

Uptake of Noninvasive Prenatal Testing in Chinese Women following Positive Down Syndrome Screening

Using population-based data to predict the impact of introducing noninvasive prenatal diagnosis for Down syndrome

Prenatal diagnosis and termination of pregnancy: perspectives of South African parents of children with Down syndrome

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