Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
Prenat Diagn. 2013 Jun;33(6):542-6. doi: 10.1002/pd.4125.
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.
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.
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%, p ≤ 0.001. Race/ethnicity and timing of results (first versus second trimester) were predictors of testing choices; payer and maternal age were not.
The introduction of NIPT resulted in a significant decrease in invasive diagnostic testing. Additionally, fewer women declined further testing when NIPT was available.
本研究旨在探讨非侵入性产前检测（NIPT）引入后对阳性产前筛查（PNS）结果后女性检测选择的影响。
自 2012 年 3 月起，在阳性 PNS 结果后转诊至我们产前诊断中心的女性可选择 NIPT 或侵入性产前诊断。与前一年的检测决策相比，比较了侵入性检测和随访率的下降情况。使用 t 检验和卡方检验比较差异。采用多变量逻辑回归分析鉴定检测选择的预测因素。
2012 年 3 月至 2013 年 2 月期间，共 398 名筛查阳性的女性就诊：156 名（39.2%）进行了侵入性检测，157 名（39.4%）进行了 NIPT，84 名（21.1%）拒绝进一步检测。前一年，共 638 名筛查阳性患者就诊：301 名（47.2%）进行了侵入性检测，337 名（52.8%）拒绝检测。侵入性检测率显著下降（p=0.012）。此外，引入 NIPT 后，拒绝进一步检测的女性比例明显下降，从 52.8%降至 21.2%，p≤0.001。种族/民族和结果时间（第一还是第二孕期）是检测选择的预测因素；支付方和产妇年龄不是。
NIPT 的引入显著降低了侵入性诊断检测率。此外，当 NIPT 可用时，拒绝进一步检测的女性比例下降。
