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接受无创性产前检测(NIPT)的女性在阳性非整倍体筛查后的情况。

Uptake of noninvasive prenatal testing (NIPT) in women following positive aneuploidy screening.

机构信息

Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Prenat Diagn. 2013 Jun;33(6):542-6. doi: 10.1002/pd.4125.

Abstract

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%, p ≤ 0.001. 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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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