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孕妇对拓宽无创产前检测范围的看法:从筛查胎儿非整倍体到预测不良妊娠结局——一项定性研究。

Perspectives of pregnant women on broadening the scope of noninvasive prenatal testing from screening for foetal aneuploidies to prediction of adverse pregnancy outcomes: A qualitative study.

机构信息

Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Department of Human Genetics, Amsterdam UMC, Amsterdam, the Netherlands.

出版信息

Prenat Diagn. 2024 Aug;44(9):1033-1042. doi: 10.1002/pd.6621. Epub 2024 Jun 14.

DOI:10.1002/pd.6621
PMID:38877376
Abstract

OBJECTIVE

To explore the perspectives of pregnant women on broadening the scope of noninvasive prenatal testing (NIPT) from screening for foetal aneuploidies to prediction of adverse pregnancy outcomes.

METHODS

Four online focus groups (n = 23 participants) and 14 individual semi-structured interviews were conducted. Participants included pregnant women with and without a history of adverse pregnancy outcomes.

RESULTS

Both women at low and high risk of adverse pregnancy outcomes had a positive attitude towards using NIPT to predict adverse pregnancy outcomes. Perceived benefits included the possibility to potentially improve maternal and foetal outcomes by taking risk-reducing measures and/or intensified monitoring during pregnancy and the ability to mentally prepare for the potential adverse outcome. Perceived concerns included anxiety and stress caused by a high-risk test result, a false sense of control over pregnancy, and potential false reassurance. Additionally, women reasoned that broadening the scope of NIPT could increase the complexity of prenatal screening and raised concerns on the combined screening aims in one test (prediction of adverse pregnancy outcomes to improve foetal and maternal health vs. screening for foetal aneuploidies to increase reproductive autonomy). On a societal level, considerations on the risk of medicalising pregnancy and overall pressure to opt for NIPT were mentioned.

CONCLUSION

In general, pregnant women have a positive attitude towards broadening the scope of NIPT to the prediction of pregnancy outcomes, although some concerns are acknowledged.

摘要

目的

探讨孕妇对拓宽无创产前检测(NIPT)范围的看法,从筛查胎儿非整倍体到预测不良妊娠结局。

方法

进行了 4 个在线焦点小组(n=23 名参与者)和 14 次个别半结构化访谈。参与者包括有和无不良妊娠结局史的孕妇。

结果

低风险和高风险不良妊娠结局的孕妇对使用 NIPT 预测不良妊娠结局均持积极态度。潜在的益处包括通过采取降低风险的措施和/或在怀孕期间加强监测,有可能改善母婴结局,以及为潜在的不良结局做好心理准备。潜在的担忧包括高危检测结果引起的焦虑和压力、对妊娠的虚假控制感,以及潜在的虚假保证。此外,女性认为拓宽 NIPT 的范围可能会增加产前筛查的复杂性,并对一项测试中同时进行的联合筛查目标提出了担忧(预测不良妊娠结局以改善胎儿和母婴健康与筛查胎儿非整倍体以增加生殖自主权)。在社会层面上,有人提到了将妊娠医学化的风险和普遍选择 NIPT 的压力。

结论

总体而言,孕妇对拓宽 NIPT 的范围以预测妊娠结局持积极态度,但也承认了一些担忧。

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引用本文的文献

1
Preferences of pregnant women and obstetric healthcare professionals on using noninvasive prenatal testing to predict adverse pregnancy outcomes: a discrete choice experiment.孕妇和产科医护人员对使用无创产前检测预测不良妊娠结局的偏好:一项离散选择实验
BMJ Open. 2025 Jan 15;15(1):e088304. doi: 10.1136/bmjopen-2024-088304.