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P01.07: cfDNA after combined screening: factors that influence patient decisions
Author(s) -
Ferreira L.C.,
Carocha A.I.,
Cohen Á.,
Cruz J.
Publication year - 2019
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.20880
Subject(s) - medicine , ductus venosus , cell free fetal dna , obstetrics , trisomy , down syndrome , fetus , singleton , risk assessment , gynecology , pregnancy , prenatal diagnosis , genetics , psychiatry , biology , computer security , computer science
Objectives: To understand factors that influence patient decision on performing cell-free DNA (cfDNA) test after combined screening. Methods: All singleton pregnancies referred to our centre for first trimester screening (FTS) were prospectively selected during one year. All fetal defects were excluded. After FTS patients receive a standard counselling based on corrected risk for Trisomy 21 (T21). After counselling the options of cfDNA, invasive test or nothing else were discussed. All tests were offered free of any charge. Data on decision, patient characteristics, obstetric history, maternal age, fetal nuchal translucency thickness, nasal bone, ductus venosus pulsatility index, tricuspid flow, maternal serum free β-hCG and PAPP-A were analysed. Parametrical and non-parametrical tests were used accordingly. Corrected risk for T21 was categorised into 3 groups: risk higher that 1:100, risk between 1:100 and 1:2500 and risk lower than 1:2500. Multiple regression analysis was performed to determined which factors influenced the decision against cfDNA test. Results: 2029 singleton pregnancies were included. The mean maternal age, NT, β-hCG and PAPP-A were 31.82 (6.07), 1.93 (0.83), 1.22 (0.86) and 1.05 (0.61) respectively. 11.5% were afrodescendent. 207 (10.2%) opted for the cfDNA test. Risk for T21 and ethnicity were the only 2 factors that remained significant in our model (table 1). Conclusions: Factors that impact patients decision are the corrected risk for T21 and ethnicity. Patients are 81% and 61% less likely to opt for cfDNA when risk is high or low respectively, when compared with intermediate risk. Patients from afrodescendent background are 55% less likely to opt for cfDNA. The authors believe that significance found in ethnicity simply reflect diverse cultural backgrounds and therefore various views in similar situations.