Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Department of Clinical Genetics and Medicine, Kyushu University Hospital, Fukuoka, Japan.
J Obstet Gynaecol Res. 2021 Nov;47(11):3813-3820. doi: 10.1111/jog.15010. Epub 2021 Sep 6.
This study aimed to evaluate changes in prenatal testing among women with twin pregnancies before and after the introduction of noninvasive prenatal testing (NIPT). To date, no consensus on prenatal testing for twin pregnancies has been reached in Japan.
Women pregnant with twins who requested prenatal testing at Kyushu Medical Center from 2005 to 2018 were included in this study. Genetic counseling was provided to all participants. Their chosen methods of testing were collected and classified as invasive diagnosis (ID), noninvasive screening (NIS), and no test requested (NR). Parity, chorionicity, and methods of conception were assessed as attributes. The study period was divided into three terms according to testing availability in our center.
After NIPT was introduced in our center, the use of ID methods decreased and eventually disappeared while NIS came to the forefront. NR was also the preferred choice of women with twin pregnancies before the introduction of NIPT and decreased but did not disappear after introducing NIPT. Women with twin pregnancies who underwent assisted reproduction initially showed hesitation to undergo testing but showed a strong preference for NIS after the introduction of NIPT. Differences in choice according to parity, chorionicity, and methods of conception were found before the introduction of NIPT but disappeared after introducing NIPT.
Increasing information about NIPT has apparently influenced the attitudes of women with twin pregnancies to prenatal testing in Japan. In particular, those who conceive through assisted reproductive technologies exhibited a strong preference for NIPT.
本研究旨在评估非侵入性产前检测(NIPT)引入前后,双胎妊娠女性产前检测的变化。迄今为止,日本尚未就双胎妊娠的产前检测达成共识。
本研究纳入了 2005 年至 2018 年在九州医疗中心因双胎妊娠要求进行产前检测的女性。所有参与者均提供了遗传咨询。收集并分类了他们选择的检测方法,分为有创诊断(ID)、非侵入性筛查(NIS)和未请求检测(NR)。评估了产次、绒毛膜性和受孕方式等属性。根据中心检测方法的可用性,将研究期间分为三个时期。
在本中心引入 NIPT 后,ID 方法的使用减少,最终消失,而 NIS 则成为主流。NR 也是 NIPT 引入前双胎妊娠女性的首选,引入 NIPT 后虽有所减少但并未消失。最初,接受辅助生殖的双胎妊娠女性对检测犹豫不决,但在引入 NIPT 后强烈倾向于 NIS。在引入 NIPT 之前,根据产次、绒毛膜性和受孕方式的选择存在差异,但引入 NIPT 后这些差异消失。
关于 NIPT 的信息不断增加,显然影响了日本双胎妊娠女性对产前检测的态度。特别是通过辅助生殖技术受孕的女性对 NIPT 表现出强烈的偏好。