Uptake of noninvasive prenatal testing (NIPT) in women following positive aneuploidy screening
Uptake of noninvasive prenatal testing (NIPT) in women following positive aneuploidy screening
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DOI：
10.1002/pd.4125
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发表时间：
2013-06-01
影响因子：
3
通讯作者：
Norton, Mary E.
中科院分区：
文献类型：
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作者：
Chetty, Shilpa;Garabedian, Matthew J.;Norton, Mary E.
目的探讨无创性产前检查（NIPT）的引入对产前筛查（PNS）阳性妇女的检测选择的影响。方法从2012年3月开始，在PNS结果阳性后转诊到我们的产前诊断中心的妇女提供NIPT或侵入性产前诊断。将侵入性检测率和随访率下降与前一年的检测决定进行比较。采用t检验和卡方检验比较差异。进行多变量逻辑回归以确定测试选择的预测因素。结果在2012年3月至2013年2月期间，共有398名筛查阳性女性：156名（39.2%）接受了侵入性检测，157名（39.4%）接受了NIPT，84名（21.1%）拒绝进一步检测。在前一年，有638名筛查阳性患者：301名（47.2%）进行了侵入性检测，337名（52.8%）下降。侵入性检测率显著下降（p=0.012）。此外，在引入NIPT后，拒绝随访检测的女性较少，分别为21.2%和52.8%，p <0.001。种族/民族和结果的时间（第一与第二孕期）是测试选择的预测因素;付款人和母亲年龄不是。结论NIPT的引入导致侵入性诊断检测的显著减少。此外，当NIPT可用时，更少的女性拒绝进一步检测。(c)2013年约翰威利父子有限公司
Objective The aim of this study was to investigate how the introduction of noninvasive prenatal testing (NIPT) impacted women's testing choices following a positive prenatal screening (PNS) result. Methods Beginning in March 2012, women referred to our Prenatal Diagnosis Center following a positive PNS result were offered NIPT or invasive prenatal diagnosis. Rates of invasive testing and declining follow-up were compared with testing decisions the prior year. Differences were compared using t-test and chi-square. Multivariable logistic regression was performed to identify predictors of test choice. Results Between March 2012 and February 2013, 398 screen positive women were seen: 156 (39.2%) underwent invasive testing, 157 (39.4%) had NIPT and 84 (21.1%) declined further testing. In the prior year, 638 screen positive patients were seen: 301 (47.2%) had invasive testing and 337 (52.8%) declined. The rate of invasive testing declined significantly (p=0.012). Moreover, fewer women declined follow-up testing after introduction of NIPT, 21.2% versus 52.8%, p0.001. Race/ethnicity and timing of results (first versus second trimester) were predictors of testing choices; payer and maternal age were not. Conclusion The introduction of NIPT resulted in a significant decrease in invasive diagnostic testing. Additionally, fewer women declined further testing when NIPT was available. (c) 2013 John Wiley & Sons, Ltd.