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新的政府参与的无创产前检测认证制度对日本孕妇无创产前检测认知度的影响。

Impact of the new government-involved noninvasive prenatal testing certification system on the awareness of pregnant women about noninvasive prenatal testing in Japan.

作者信息

Shirato Nahoko, Sekizawa Akihiko, Miyagami Keiko, Sakamoto Miwa, Yamada Takahiro, Hirose Tatsuko, Ikebukuro Shin, Nakamura Takeshi, Mizutani Akane, Ikemoto Mai, Izum Mikiko, Seino Hitomi, Yamada Shigehito, Suzumori Nobuhiro, Yoshihashi Hiroshi, Samura Osamu, Sawai Hideaki, Sago Haruhiko, Okuyama Torayuki

机构信息

Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.

Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan.

出版信息

J Obstet Gynaecol Res. 2024 Sep;50(9):1542-1551. doi: 10.1111/jog.16052. Epub 2024 Aug 14.

Abstract

AIM

In Japan, noninvasive prenatal testing (NIPT) has been performed by facilities accredited by the Japanese Society of Obstetrics and Gynecology since 2013. However, since 2016, with the implementation of NIPT, which can only be performed by blood sampling, non-obstetricians have been involved in prenatal testing. Therefore, in July 2022, a new government-involved NIPT certification system based on Health Sciences Council guidelines was introduced to ensure access to prenatal testing information for pregnant women.

METHODS

This survey was conducted in February 2023 and was the first survey after the certification system implementation. We conducted a web-based survey of 1227 pregnant women and nursing mothers who underwent NIPT after July 2022 to evaluate their experiences.

RESULTS

Respondents were categorized by certification status as certified (C: 56%), non-certified (non-C: 23%), or uncertain (Q: 20%). The C group with a higher mean age at examination (35.0 ± 4.5 years) paid lower examination fees, received longer pre- and post-examination explanations, and underwent more weekday examinations (80%) than the other groups. Most respondents, 67%, 48%, and 53% in the C, non-C, and Q groups, respectively (p < 0.0001), stated that "NIPT needs to be regulated by the government or academic societies." The non-C group was more likely to say, "Insufficient post-test explanations at the laboratory made me more anxious," than the other groups when the testing results were non-negative (p = 0.015).

CONCLUSIONS

Despite government regulation, some pregnant women choose convenience over certified facilities, risking inadequate care. The government should ensure that NIPT is a safe option for all pregnant women.

摘要

目的

在日本,自2013年以来,非侵入性产前检测(NIPT)一直由日本妇产科学会认可的机构进行。然而,自2016年起,随着只能通过血液采样进行的NIPT的实施,非产科医生也参与到了产前检测中。因此,2022年7月,基于健康科学委员会指南引入了一种新的政府参与的NIPT认证系统,以确保孕妇能够获取产前检测信息。

方法

本调查于2023年2月进行,是认证系统实施后的首次调查。我们对2022年7月后接受NIPT的1227名孕妇和哺乳期母亲进行了网络调查,以评估她们的经历。

结果

受访者按认证状态分为已认证(C组:56%)、未认证(非C组:23%)或不确定(Q组:20%)。与其他组相比,C组检查时平均年龄较高(35.0±4.5岁),检查费用较低,接受的检查前和检查后解释时间更长,且在工作日进行检查的比例更高(80%)。C组、非C组和Q组中分别有67%、48%和53%的大多数受访者(p<0.0001)表示“NIPT需要由政府或学术团体进行监管”。当检测结果为非阴性时,非C组比其他组更有可能表示“实验室检查后解释不足让我更加焦虑”(p=0.015)。

结论

尽管有政府监管,但一些孕妇选择便利性而非认证机构,存在护理不足的风险。政府应确保NIPT对所有孕妇来说都是一个安全的选择。

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