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Offering non-invasive prenatal testing as part of routine clinical service. Can high levels of informed choice be maintained?

Lewis, C; Hill, M; Chitty, LS; (2017) Offering non-invasive prenatal testing as part of routine clinical service. Can high levels of informed choice be maintained? Prenatal Diagnosis , 37 (11) pp. 1130-1137. 10.1002/pd.5154. Green open access

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Abstract

OBJECTIVES: To assess rates of informed choice among women offered NIPT for aneuploidy as part of routine clinical care. METHODS: A cross-sectional survey was conducted across six antenatal clinics in England. Women with a high risk (≥1/150) Down syndrome screening result were offered NIPT, invasive testing or no further testing. Pre-test counselling was delivered as part of routine care by the local maternity team. Women were given a questionnaire containing a measure of informed choice immediately after pre-test counselling. RESULTS: In total, 220/247 women completed the questionnaire. Seventy six percent were judged to have made an informed choice, a significant decline from our previous study (89.0% v 75.6%; X(2) (2)=20.2, p<0.001). Of those making an uninformed choice, 46% had insufficient knowledge, 19% had not deliberated and 13% had made a value-inconsistent decision. Multivariate analysis showed women who were highly educated (OR 4.33; 95% CI 1.08-17.36) or had had screening in a previous pregnancy (OR 0.24; 95% CI 0.90-0.65) were significantly more likely to make an informed choice. CONCLUSIONS: The findings highlight the challenges of ensuring informed choice in routine prenatal care where NIPT is not discussed at multiple points, less time is available for counselling and written consent is not required.

Type: Article
Title: Offering non-invasive prenatal testing as part of routine clinical service. Can high levels of informed choice be maintained?
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/pd.5154
Publisher version: http://doi.org/10.1002/pd.5154
Language: English
Additional information: Copyright © 2017 The Authors Prenatal Diagnosis published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Genetics and Genomic Medicine Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1574606
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