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Women's Attitudes Toward Invasive and Noninvasive Testing When Facing a High Risk of Fetal Down Syndrome
Valerie Seror1,2, Olivier L'Haridon3, Laurence Bussières4,5
1Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.
JAMA Network Open
|March 30, 2019
Summary
Most pregnant women at high risk for Down syndrome (DS) prefer noninvasive prenatal testing (NIPT) over invasive testing (IT) due to risk aversion. Decision-making aligns with attitudes, emphasizing the need for comprehensive information on both tests.
Area of Science:
- Prenatal diagnostics
- Genetics
- Maternal-fetal medicine
Background:
- Noninvasive prenatal testing (NIPT) using cell-free DNA is increasingly used for antenatal detection of Down syndrome (DS).
- Invasive testing (IT) remains an option for definitive diagnosis.
Purpose of the Study:
- To assess the attitudes and decision-making processes of pregnant women at high risk for fetal DS.
- To understand factors influencing the choice between NIPT and IT.
Main Methods:
- A survey study involving 2436 pregnant women at high risk for fetal DS in France.
- Data collected on attitudes before randomization and decision-making during a clinical trial.
- Hierarchical cluster analysis and logistic regression were used to analyze attitudes and influencing factors.
Main Results:
- 75.7% of women favored NIPT, while 21.1% preferred IT with complete karyotyping.
- Four distinct clusters of attitudes were identified, primarily differing in risk-taking and information-seeking preferences.
- Age, religious beliefs, nuchal translucency, and education level were associated with specific attitudes.
Conclusions:
- Aversion to the risks of invasive procedures and the ambiguity of NIPT significantly shape patient choices.
- Informed decision-making requires comprehensive counseling on the specific abnormalities detected by both NIPT and IT.