Has noninvasive prenatal testing impacted termination of pregnancy and live birth rates of infants with Down syndrome?
Hill, M Barrett, A Choolani, M Lewis, C Fisher, J Chitty, L.S
Hill, M
Lewis, C
Fisher, J
Chitty, L.S
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Abstract
Background: Implementation of noninvasive prenatal testing (NIPT) as a highly accurate aneuploidy screening test has raised questions around whether the high uptake may result in more terminations of pregnancies and fewer births of children with Down syndrome (DS). Aim: The aim of the study was to investigate the impact of NIPT on termination and live birth rates for DS. Methods: Literature reporting pregnancy outcomes following NIPT was reviewed. Termination rates were calculated for women with a high-risk NIPT result for DS. Two audits of pregnancy outcomes where NIPT indicated DS were conducted in the United Kingdom and Singapore. Results: Fourteen studies from the United States, Asia, Europe, and the United Kingdom were included in the review. Live births of children with DS were reported in 8 studies. Termination rates following NIPT were unchanged or decreased when compared to termination rates prior to the introduction of NIPT. Audits found 15 of 43 women in the United Kingdom and 2 of 6 in Singapore continued pregnancies following a high-risk NIPT result. Conclusions: Termination rates following the detection of DS by NIPT are unchanged or decreased compared to historical termination rates. Impact on live birth rates may be minimal in settings where termination rates fall. Population-based studies are required to determine the true impact. © 2017 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.
Keywords
adult, Article, clinical audit, controlled study, Down syndrome, Europe, female, high risk patient, human, infant, live birth, major clinical study, noninvasive prenatal test, pregnancy outcome, pregnancy rate, pregnancy termination, pregnancy test, prenatal screening, priority journal, Singapore, United Kingdom, United States, Down syndrome, induced abortion, maternal serum screening test, pregnancy, statistics and numerical data, Abortion, Induced, Down Syndrome, Female, Humans, Maternal Serum Screening Tests, Pregnancy, Singapore, United Kingdom
Source Title
Prenatal Diagnosis
Publisher
John Wiley and Sons Ltd
Series/Report No.
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Rights
Attribution 4.0 International
Date
2017
DOI
10.1002/pd.5182
Type
Article