An Chen1, Henni Tenhunen1, Paulus Torkki1, Seppo Heinonen2, Paul Lillrank1, Vedran Stefanovic2. 1. Aalto University, Institute of Healthcare Engineering, Management and Architecture (HEMA), Finland. 2. Fetomaternal Medical Center, Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Finland.
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.
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.
Authors: Tuomas Kvist; Sara Sammallahti; Marius Lahti-Pulkkinen; Cristiana Cruceanu; Darina Czamara; Linda Dieckmann; Alina Tontsch; Simone Röh; Monika Rex-Haffner; Eiina Wolford; Rebecca Reynolds; Johan Eriksson; Sanna Suomalainen-König; Hannele Laivuori; Eero Kajantie; Eija Lahdensuo; Elisabeth Binder; Katri Räikkönen Journal: BMJ Open Date: 2022-01-31 Impact factor: 2.692