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美国黑人女性对无创性产前检测的看法:范围综述。

Patient perspectives on noninvasive prenatal testing among black women in the United States: a scoping review.

机构信息

School of Public Health, Harvard University, Cambridge, USA.

National Institutes of Health-National Genome Research Institute, Bethesda, USA.

出版信息

BMC Pregnancy Childbirth. 2023 Mar 16;23(1):183. doi: 10.1186/s12884-023-05423-w.

Abstract

Advances in reproductive health technologies such as noninvasive prenatal testing (NIPT) are changing the landscape of prenatal care and maternal health. NIPT, made clinically available in the United States (US) in 2011, is a screening test that utilizes cell-free DNA (cfDNA) to detect for aneuploidies and genetic characteristics in fetal DNA. In September 2020, the American College of Obstetricians and Gynecologists (ACOG) recommended NIPT for all pregnant patients regardless of age or risk factors. We examined peer-reviewed, empirical studies published from January 2011 to February 2022, assessing NIPT studies with patient perspectives in the US and what is known about how empirical studies include Black women. Our scoping review draws from PubMed (with advanced MeSH search options) and Scopus databases for advanced scoping review, with 33 articles meeting our criteria. Empirical studies on NIPT show patient perceptions range across five themes: 1) accuracy / safety, 2) return of results, 3) patient knowledge, 4) informed consent, and 5) perceptions among minoritized groups (with perceptions of race and gender as a social demographic intersection). Additionally, among the 15 studies that included that Black woman in their study sample, none measured the perceptions of Black women with genetic conditions. Bridging this knowledge gap is critical because NIPT is becoming increasingly accessible across the nation and is being developed to screen for additional genetic conditions, such as sickle cell disease. Ultimately, NIPT researchers need to go to greater lengths to examine the patient perspectives of Black women with and without genetic conditions.

摘要

生殖健康技术的进步,如非侵入性产前检测(NIPT),正在改变产前护理和孕产妇健康的格局。NIPT 于 2011 年在美国(US)获得临床应用,是一种利用游离胎儿 DNA(cfDNA)检测胎儿 DNA 中染色体非整倍体和遗传特征的筛查测试。2020 年 9 月,美国妇产科医师学会(ACOG)建议所有孕妇(无论年龄或风险因素如何)都进行 NIPT。我们检查了 2011 年 1 月至 2022 年 2 月期间发表的同行评议的实证研究,评估了美国从患者角度进行的 NIPT 研究以及关于实证研究如何纳入黑人女性的情况。我们的范围综述来自 PubMed(使用高级 MeSH 搜索选项)和 Scopus 数据库进行高级范围综述,其中 33 篇文章符合我们的标准。关于 NIPT 的实证研究表明,患者的看法主要包括五个主题:1)准确性/安全性,2)结果回报,3)患者知识,4)知情同意,以及 5)少数群体的看法(种族和性别看法作为社会人口交叉点)。此外,在纳入研究样本的 15 项研究中,没有一项研究测量了有遗传疾病的黑人女性的看法。弥合这一知识差距至关重要,因为 NIPT 在全国范围内的可及性越来越高,并且正在开发用于筛查其他遗传疾病,如镰状细胞病。最终,NIPT 研究人员需要更加努力地研究有和没有遗传疾病的黑人女性的患者观点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dee8/10018979/e6629c31d63b/12884_2023_5423_Fig1_HTML.jpg

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