Bruce Lefroy Centre, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
Prenat Diagn. 2020 Mar;40(4):398-407. doi: 10.1002/pd.5555. Epub 2019 Oct 10.
Non-invasive prenatal testing (NIPT) can determine the sex of the fetus very accurately and very early in gestation. There are concerns that the ease, timing, and accuracy of NIPT sex determination will facilitate sex-selective termination of pregnancy (TOP). Here, we review current practices, the evidence for a link between NIPT and sex-selective TOP, and associated ethical issues. Sex-selective TOP, usually motivated by son preference, has had serious demographic consequences in countries such as India and China. Currently, ultrasound is the primary method by which parents determine the sex of the fetus. The diffusion of ultrasound technology has had a direct impact on the rates of sex-selective TOP. Although NIPT is currently more costly, it is feasible that increased uptake of this technology could have a similar effect. Partly because NIPT is a relatively recent development in prenatal screening, there is little data on the impact of NIPT on sex selection practices. Evidence that NIPT is playing a role in sex-selective TOP remains largely anecdotal. Further research is required to assess and quantify TOP resulting from NIPT sex determination. The use of these technologies for sex selection raises a number of ethical issues, in addition to practical demographic consequences.
非侵入性产前检测（NIPT）可以非常准确和早期地确定胎儿的性别。有人担心，NIPT 性别检测的简便性、时间和准确性将促进选择性终止妊娠（TOP）。在这里，我们回顾了当前的实践、NIPT 与性别选择性 TOP 之间的联系的证据以及相关的伦理问题。性别选择性 TOP 通常是出于男孩偏好的动机，在印度和中国等国家产生了严重的人口后果。目前，超声是父母确定胎儿性别的主要方法。超声技术的普及对性别选择性 TOP 的比率产生了直接影响。尽管 NIPT 目前的成本更高，但随着这项技术的普及，它可能会产生类似的影响。部分原因是 NIPT 是产前筛查的一项相对较新的发展，因此关于 NIPT 对性别选择实践的影响的数据很少。NIPT 在性别选择性 TOP 中发挥作用的证据在很大程度上仍只是传闻。需要进一步的研究来评估和量化 NIPT 性别检测导致的 TOP。除了实际的人口后果外，这些技术的性别选择用途还引发了许多伦理问题。
