Trial by Dutch Laboratories for Evaluation of Non-Invasive Prenatal Testing. Part II - Women's Perspectives

Rachel V van Schendel; Lieve Page-Christiaens; Lean Beulen; Catia M Bilardo; Marjon A de Boer; Audrey B C Coumans; Brigitte H Faas; Irene M van Langen; Klaske D Lichtenbelt; Merel C van Maarle; Merryn V E Macville; Dick Oepkes; Eva Pajkrt; Lidewij Henneman

doi:10.1002/pd.4941

Trial by Dutch Laboratories for Evaluation of Non-Invasive Prenatal Testing. Part II - Women's Perspectives

Rachel V van Schendel, Lieve Page-Christiaens, Lean Beulen, Catia M Bilardo, Marjon A de Boer, Audrey B C Coumans, Brigitte H Faas, Irene M van Langen, Klaske D Lichtenbelt, Merel C van Maarle, Merryn V E Macville, Dick Oepkes, Eva Pajkrt, Lidewij Henneman,

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Abstract

OBJECTIVE: To evaluate preferences and decision-making amongst high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing.

METHODS: Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice.

RESULTS: 1091/1253 (87%) women completed the questionnaire. Of these, 1053 (96.5%) underwent NIPT, 37 (3.4%) invasive testing and 1 (0.1%) declined testing. 91.7% preferred NIPT because of test safety. 77.9% made an informed choice, 89.8% had sufficient knowledge and 90.5% had positive attitudes towards NIPT. Women with intermediate (Odds Ratio(OR) = 3.51[1.70-7.22],p < 0.001) or high educational level (OR = 4.36[2.22-8.54],p < 0.001) and women with adequate health literacy (OR = 2.60[1.36-4.95],p = 0.004) were more likely to make an informed choice. Informed choice was associated with less decisional conflict and less anxiety (p < 0.001). Intention to terminate the pregnancy for Down syndrome was higher among women undergoing invasive testing (86.5%) compared to those undergoing NIPT (58.4%)(p < 0.001).

CONCLUSIONS: The majority of women had sufficient knowledge and made an informed choice. Continuous attention for counseling is required, especially for low-educated and less health-literate women.

Original language	English
Pages (from-to)	1091–1098
Journal	Prenatal Diagnosis
Volume	36
Issue number	12
DOIs	https://doi.org/10.1002/pd.4941
Publication status	Published - Dec 2016

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van Schendel, R. V., Page-Christiaens, L., Beulen, L., Bilardo, C. M., de Boer, M. A., Coumans, A. B. C., Faas, B. H., van Langen, I. M., Lichtenbelt, K. D., van Maarle, M. C., Macville, M. V. E., Oepkes, D., Pajkrt, E., Henneman, L. (2016). Trial by Dutch Laboratories for Evaluation of Non-Invasive Prenatal Testing. Part II - Women's Perspectives. Prenatal Diagnosis, 36(12), 1091–1098 . https://doi.org/10.1002/pd.4941

@article{0858638aae9148eb9624772bc11b30bd,

title = "Trial by Dutch Laboratories for Evaluation of Non-Invasive Prenatal Testing. Part II - Women's Perspectives",

abstract = "OBJECTIVE: To evaluate preferences and decision-making amongst high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing.METHODS: Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice.RESULTS: 1091/1253 (87%) women completed the questionnaire. Of these, 1053 (96.5%) underwent NIPT, 37 (3.4%) invasive testing and 1 (0.1%) declined testing. 91.7% preferred NIPT because of test safety. 77.9% made an informed choice, 89.8% had sufficient knowledge and 90.5% had positive attitudes towards NIPT. Women with intermediate (Odds Ratio(OR) = 3.51[1.70-7.22],p < 0.001) or high educational level (OR = 4.36[2.22-8.54],p < 0.001) and women with adequate health literacy (OR = 2.60[1.36-4.95],p = 0.004) were more likely to make an informed choice. Informed choice was associated with less decisional conflict and less anxiety (p < 0.001). Intention to terminate the pregnancy for Down syndrome was higher among women undergoing invasive testing (86.5%) compared to those undergoing NIPT (58.4%)(p < 0.001).CONCLUSIONS: The majority of women had sufficient knowledge and made an informed choice. Continuous attention for counseling is required, especially for low-educated and less health-literate women.",

author = "{van Schendel}, {Rachel V} and Lieve Page-Christiaens and Lean Beulen and Bilardo, {Catia M} and {de Boer}, {Marjon A} and Coumans, {Audrey B C} and Faas, {Brigitte H} and {van Langen}, {Irene M} and Lichtenbelt, {Klaske D} and {van Maarle}, {Merel C} and Macville, {Merryn V E} and Dick Oepkes and Eva Pajkrt and Lidewij Henneman",

year = "2016",

month = dec,

doi = "10.1002/pd.4941",

language = "English",

volume = "36",

pages = "1091–1098 ",

journal = "Prenatal Diagnosis",

issn = "0197-3851",

publisher = "John Wiley & Sons Inc.",

number = "12",

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van Schendel, RV, Page-Christiaens, L, Beulen, L, Bilardo, CM, de Boer, MA, Coumans, ABC, Faas, BH, van Langen, IM, Lichtenbelt, KD, van Maarle, MC, Macville, MVE, Oepkes, D, Pajkrt, E, Henneman, L 2016, 'Trial by Dutch Laboratories for Evaluation of Non-Invasive Prenatal Testing. Part II - Women's Perspectives', Prenatal Diagnosis, vol. 36, no. 12, pp. 1091–1098 . https://doi.org/10.1002/pd.4941

TY - JOUR

T1 - Trial by Dutch Laboratories for Evaluation of Non-Invasive Prenatal Testing. Part II - Women's Perspectives

AU - van Schendel, Rachel V

AU - Page-Christiaens, Lieve

AU - Beulen, Lean

AU - Bilardo, Catia M

AU - de Boer, Marjon A

AU - Coumans, Audrey B C

AU - Faas, Brigitte H

AU - van Langen, Irene M

AU - Lichtenbelt, Klaske D

AU - van Maarle, Merel C

AU - Macville, Merryn V E

AU - Oepkes, Dick

AU - Pajkrt, Eva

AU - Henneman, Lidewij

PY - 2016/12

Y1 - 2016/12

N2 - OBJECTIVE: To evaluate preferences and decision-making amongst high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing.METHODS: Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice.RESULTS: 1091/1253 (87%) women completed the questionnaire. Of these, 1053 (96.5%) underwent NIPT, 37 (3.4%) invasive testing and 1 (0.1%) declined testing. 91.7% preferred NIPT because of test safety. 77.9% made an informed choice, 89.8% had sufficient knowledge and 90.5% had positive attitudes towards NIPT. Women with intermediate (Odds Ratio(OR) = 3.51[1.70-7.22],p < 0.001) or high educational level (OR = 4.36[2.22-8.54],p < 0.001) and women with adequate health literacy (OR = 2.60[1.36-4.95],p = 0.004) were more likely to make an informed choice. Informed choice was associated with less decisional conflict and less anxiety (p < 0.001). Intention to terminate the pregnancy for Down syndrome was higher among women undergoing invasive testing (86.5%) compared to those undergoing NIPT (58.4%)(p < 0.001).CONCLUSIONS: The majority of women had sufficient knowledge and made an informed choice. Continuous attention for counseling is required, especially for low-educated and less health-literate women.

AB - OBJECTIVE: To evaluate preferences and decision-making amongst high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing.METHODS: Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice.RESULTS: 1091/1253 (87%) women completed the questionnaire. Of these, 1053 (96.5%) underwent NIPT, 37 (3.4%) invasive testing and 1 (0.1%) declined testing. 91.7% preferred NIPT because of test safety. 77.9% made an informed choice, 89.8% had sufficient knowledge and 90.5% had positive attitudes towards NIPT. Women with intermediate (Odds Ratio(OR) = 3.51[1.70-7.22],p < 0.001) or high educational level (OR = 4.36[2.22-8.54],p < 0.001) and women with adequate health literacy (OR = 2.60[1.36-4.95],p = 0.004) were more likely to make an informed choice. Informed choice was associated with less decisional conflict and less anxiety (p < 0.001). Intention to terminate the pregnancy for Down syndrome was higher among women undergoing invasive testing (86.5%) compared to those undergoing NIPT (58.4%)(p < 0.001).CONCLUSIONS: The majority of women had sufficient knowledge and made an informed choice. Continuous attention for counseling is required, especially for low-educated and less health-literate women.

U2 - 10.1002/pd.4941

DO - 10.1002/pd.4941

M3 - Article

C2 - 27739584

SN - 0197-3851

VL - 36

SP - 1091

EP - 1098

JO - Prenatal Diagnosis

JF - Prenatal Diagnosis

IS - 12

ER -

Trial by Dutch Laboratories for Evaluation of Non-Invasive Prenatal Testing. Part II - Women's Perspectives

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