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The influence of noninvasive prenatal testing on gestational age at time of abortion for aneuploidy
Author(s) -
Lassey Sarah C.,
Reiff Emily S.,
Dobson Lori,
Bromley Bryann,
WilkinsHaug Louise,
Bartz Deborah,
Little Sarah E.
Publication year - 2017
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.5050
Subject(s) - medicine , obstetrics , gestational age , trisomy , aneuploidy , abortion , gynecology , cohort , pregnancy , biology , biochemistry , genetics , gene , chromosome
Objective The objective of this study is to compare the gestational age at termination for trisomy 13, 18, or 21 (aneuploidy) before and after the introduction of noninvasive prenatal testing (NIPT). Methods A retrospective cohort of women undergoing termination for aneuploidy at two academic institutions and one private clinic. We compared two time periods: before and after the introduction of NIPT (2006–2011 and 2012–2014, respectively). Maternal demographics and clinical characteristics were abstracted from the medical record. Nonparametric statistical methods were used to compare the two cohorts. Results Our cohort included 93 women: 41 prior to NIPT and 52 post‐NIPT. Maternal age (38 post‐NIPT vs 37 pre‐NIPT; p = 0.17) did not differ between the time periods. Women in the post‐NIPT were less likely to undergo diagnostic testing (82.7% vs 97.6%; p < 0.01) before proceeding to abortion after a positive screening result. In the post‐NIPT period, there was a significant decrease in the gestational age at time of invasive testing (13.0 vs 15.7 weeks; p < 0.01) and women were more likely to undergo chorionic villous sampling (CVS) (59.6% vs 41.5%; p < 0.01). There was a significant decrease in the gestational age at termination (14.2 vs 17.2; p < 0.01). Women in the post‐NIPT group were less likely to have terminations after 16 weeks (25.0% vs 61.0%; p < 0.01), 18 weeks (7.7% vs 39.0%; p < 0.01), or 20 weeks (3.9% vs 12.2%; p = 0.23). Conclusion With the introduction of NIPT, the median gestational age at diagnosis and termination for women with Trisomy 13, 18, or 21 was 3 weeks earlier. Women were four times less likely to have a termination after 18 weeks and three times less likely to have a termination after 20 weeks. © 2017 John Wiley & Sons, Ltd.