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Women's views and the impact of noninvasive prenatal testing on procedures in a managed care setting
Author(s) -
Tiller George E.,
Kershberg Hilary B.,
Goff John,
Coffeen Christin,
Liao Wayne,
Sehnert Amy J.
Publication year - 2015
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4495
Subject(s) - prenatal care , medicine , prenatal diagnosis , obstetrics , pregnancy , intensive care medicine , fetus , environmental health , biology , genetics , population
Objective To prospectively determine the impact of noninvasive prenatal testing (NIPT) on invasive procedure utilization in a managed care setting and to elucidate women's views. Methods Pregnant women at 10–20 weeks' gestation with high‐risk indications for fetal aneuploidy in the Kaiser Permanente Southern California organization were eligible. Enrolled patients received routine prenatal counseling, completed a questionnaire and were offered the option of NIPT by a genetic counselor. Downstream data through 28 weeks' gestation were collected from the electronic medical record (EMR). The EMR was also used to identify a matched historical cohort from 1 year prior to NIPT availability. Rates of invasive prenatal procedures were compared using McNemar's test. Results Two hundred women completed the questionnaire and underwent NIPT. Twenty‐two subjects (11%) in the prospective cohort underwent an invasive prenatal procedure compared with 58 (29%) in the historical cohort ( p <0.0001). Safety and accuracy were the most important factors in considering NIPT. At the time of survey, only 12% indicated being very comfortable with the possibility of undergoing amniocentesis. Conclusion This prospective study demonstrates a 62% reduction in invasive prenatal procedures after NIPT testing and finds safety, accuracy, and personal beliefs key to women's decision‐making. © 2014 John Wiley & Sons, Ltd.