Abstract
Due to the favorable test characteristics of the non-invasive prenatal test (NIPT) in the screening of fetal aneuploidy, there has been a strong and growing demand for implementation. In the Netherlands, NIPT is offered within a governmentally supported screening program as a first-tier screening test for all pregnant women (TRIDENT-2 study). However, concerns have been raised that the test’s favorable characteristics might lead to uncritical use, also referred to as routinization. This study addresses women’s perspectives on prenatal screening with NIPT by evaluating three aspects related to routinization: informed choice, freedom to choose and (personal and societal) perspectives on Down syndrome. Nationwide, a questionnaire was completed by 751 pregnant women after receiving counseling for prenatal screening. Of the respondents, the majority (75.5%) made an informed choice for prenatal screening as measured by the multidimensional measure of informed choice (MMIC). Education level and religious affiliation were significant predictors of informed choice. The main reason to accept screening was “seeking reassurance” (25.5%), and the main reason to decline was “every child is welcome” (30.6%). The majority of respondents (87.7%) did not perceive societal pressure to test. Differences between test-acceptors and test-decliners in personal and societal perspectives on Down syndrome were found. Our study revealed high rates of informed decision-making and perceived freedom to choose regarding fetal aneuploidy screening, suggesting that there is little reason for concern about routinization of NIPT based on the perspectives of Dutch pregnant women. Our findings highlight the importance of responsible implementation of NIPT within a national screening program.
Highlights
Fetal aneuploidy screening allows couples to assess their risk for fetal anomalies (e.g., Down syndrome) and to make informed reproductive decisions [1]
High levels of informed choice were found in our sample
Informed choice In this survey study, 75.3% of women offered non-invasive prenatal test (NIPT) made an informed choice for fetal aneuploidy screening
Summary
Fetal aneuploidy screening allows couples to assess their risk for fetal anomalies (e.g., Down syndrome) and to make informed reproductive decisions (e.g., preparing for the birth of an affected child or terminating the pregnancy) [1]. The favorable characteristics of NIPT (accuracy, non-invasiveness, and early application) have led to a strong demand for implementation Driven by both pregnant women and commercial industry [4], NIPT has disseminated quickly across the globe [5, 6]. There are concerns that the favorable characteristics of NIPT combined with its simple application may lead to the test becoming a routine part of prenatal care: offered to and accepted by pregnant women without proper counseling and/or consideration [12]. These concerns are often referred to as the “routinization” of fetal aneuploidy screening. KaterKuipers et al [15] distinguished various interpretations of the routinization concept used in scientific literature into three
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
