Lewkowitz A K, Kaimal A J, Thao K, O'Leary A, Nseyo O, Kuppermann M
Department of Obstetrics &Gynecology, Washington University in St Louis, St Louis, MO, USA.
Department of Obstetrics, Gynecology &Reproductive Sciences, University of California, San Francisco, CA, USA.
J Perinatol. 2017 Jul;37(7):772-777. doi: 10.1038/jp.2017.66. Epub 2017 May 11.
To identify characteristics associated with undergoing cell-free DNA (cfDNA) and multiple marker screening (MMS) simultaneously or redundantly (after receiving negative results from the first screening test) among women aged ⩾35 years.
Participants presenting for prenatal testing completed a questionnaire that included measures of pregnancy worry and attitudes toward potential testing outcomes; data on prenatal test use was obtained via medical record review. We used multivariable logistic regression to identify factors associated with redundant or simultaneous screening.
Among 164 participants, 69 (42.1%) had cfDNA redundantly (n=51) to, or simultaneously (n=18) with, MMS. Compared with the 46 MMS-negative women who did not undergo further testing, those who underwent redundant or simultaneous cfDNA/MMS screening were more likely to have annual family incomes >$150 000, to feel having a miscarriage would be worse than having an intellectually disabled child, to desire comprehensive testing for intellectual disability and to have more pregnancy worry.
Providers who counsel patients on prenatal aneuploidy screening tests should explain the appropriate utilization of these screening tests to avoid unnecessary or minimally informative use of multiple tests.
确定35岁及以上女性同时或重复进行游离DNA(cfDNA)和多项标志物筛查(MMS)(在首次筛查试验结果为阴性后)的相关特征。
前来进行产前检测的参与者完成了一份问卷,其中包括对妊娠担忧程度和对潜在检测结果的态度的测量;通过病历审查获取产前检测使用情况的数据。我们使用多变量逻辑回归来确定与重复或同时筛查相关的因素。
在164名参与者中,69名(42.1%)对MMS进行了重复(n = 51)或同时(n = 18)的cfDNA检测。与46名未进行进一步检测的MMS阴性女性相比,那些进行了重复或同时cfDNA/MMS筛查的女性更有可能家庭年收入超过15万美元,认为流产比生一个智障儿童更糟糕,希望对智力残疾进行全面检测,并且有更多的妊娠担忧。
为患者提供产前非整倍体筛查试验咨询的医疗服务提供者应解释这些筛查试验的合理使用方法,以避免不必要或信息价值不大的多次检测。