Decision outcomes in women offered noninvasive prenatal test (NIPT) for positive Down screening results
Abstract
Tsz-Kin Loa*, Kelvin Yuen-Kwong Chanb, Anita Sik-Yau Kanb, Po-Lam Soc, Choi-Wah Kongd, Shui-Lam Make & Chung-Nin Leefa Department of Obstetrics & Gynecology, Princess Margaret Hospital, Hong Kong, China; b Prenatal Diagnostic Laboratory, Department of Obstetrics and Gynecology, Tsan Yuk Hospital, Queen Mary Hospital, Hong Kong, China; c Department of Obstetrics & Gynecology, Tuen Mun Hospital, Hong Kong, China; d Department of Obstetrics & Gynecology, United Christian Hospital, Hong Kong, China; e Department of Obstetrics & Gynecology, Queen Elizabeth Hospital, Hong Kong, China; f Department of Obstetrics & Gynecology, Pamela Youde Nethersole Easten Hospital, Hong Kong, ChinaCONTACT Tsz-Kin Lo lo_tsz_kin@yahoo.com.hk Department of Obstetrics & Gynecology, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, ChinaAbstractIn this first Asian study, the decision outcomes (decision conflict, decision regret, and anxiety) of 262 pregnant women offered noninvasive prenatal test (NIPT) for high-risk Down screening results were assessed. Decision conflict was experienced by 3.5% and level of decisional regret low (mean score 15.7, 95%CI 13.2–18.3). All 13 cases of decisional regret were NIPT acceptors. Elevated anxiety was experienced by 55.9% at the time of decision making about NIPT and persistent in 30.3%. Insufficient knowledge about NIPT was associated with elevated anxiety at decision making (p = .011) and with decisional regret (p = .016). Decisional regret was associated with prolonged anxiety (p = .010).
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Four included studies assessed anxiety with the Spielberger State-Trait Anxiety Inventory (STAI or short form STAI-6).
“Four studies assessed anxiety with the Spielberger State-Trait Anxiety Inventory (STAI or short form STAI-6) [20–22, 24].”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [21]
The scoping review identified seven studies that investigated psychological and/or social consequences after NIPT.
“In this scoping review, we identified seven studies that investigated psychological and/or social consequences after NIPT [19–25].”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [21]
Among the n = 13 women experiencing decisional regret in Lo et al., all but one had received negative NIPT results.
“Interestingly, among the n = 13 women experiencing decisional regret in the study of Lo et al. [21], all but one had received negative NIPT results.”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [21]
In the two studies that found low levels of decisional regret after receiving NIPT results, the participating women had received either positive or negative results, and no control group without NIPT was examined.
“Similarly, in the two studies [20, 21] that found low levels of decisional regret after receiving NIPT results, the participating women had received either positive or negative results; no control group without NIPT was examined in the studies.”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [21]
Most included studies recruited women with an elevated Down syndrome screening risk, while two studies recruited from an unselected population regarding Down syndrome screening.
“Most studies recruited women with an elevated Down syndrome screening (DSS) risk (medium and/or high risk, cut-offs vary, range from > 1:1000 to 1:1–125) [20–22, 24, 25], two studies recruited from an unselected population regarding DSS [19, 23].”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [21]
All included studies except one reported limitations, for example lack of a control group without NIPT, low response rates, or origin of participating women from a selected community.
“All studies except one [21] reported limitations, for example, lack of control group (i.e. without NIPT), low response rates (i.e. to initial recruiting or second questionnaires), or origin of participating women from a selected community (i.e. older and highly educated).”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [21]
Five included studies assessed anxiety, psychological distress and/or decisional regret with validated psychological tests such as STAI, PRAQ-R, K6 or DRS.
“Five studies assessed anxiety, psychological distress and/or decisional regret with validated psychological tests like the Spielberger State-Trait Anxiety Inventory (STAI or short form STAI-6), the Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R), the Kessler Psychological Distress Scale (K6) or the Decisional Regret Scale (DRS) [20–24].”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [21]
Cites
Marteau, T. M., & Bekker, H. (1992) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1992.tb00997.x · Cited by 3,238 · see citing works
BENN, P. A., BORRELL, A., Chiu, R. W. K., Cuckle, H., Dugoff, L., Faas, B. H. W., Gross, S. J., Huang, T., Johnson, J.-A. M., Maymon, R., et al. (2015) · Prenatal Diagnosis · doi:10.1002/pd.4608 · Cited by 293 · see citing works
Lewis, C., Hill, M., & Chitty, L. S. (2016) · PLOS ONE · doi:10.1371/journal.pone.0153147 · Cited by 85 · see citing works
Beulen, L., van den Berg, M., Faas, B. H. W., Feenstra, I., Hageman, M., van Vugt, J. M. G., & Bekker, M. N. (2016) · European Journal of Human Genetics · doi:10.1038/ejhg.2016.39 · Cited by 78 · see citing works
Informed choice and decision making in women offered cell‐free DNA prenatal genetic screening
Lo, T. K., Chan, K. Y. K., Kan, A. S. Y., So, P., Kong, C., Mak, S., & Lee, C.-N. (2016) · Prenatal Diagnosis · doi:10.1002/pd.4994 · Cited by 11 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Non invasive prenatal testing (NIPT) for common aneuploidies and beyond
Alberry, M., Hamed, E. S., Ahmed, S. R., & Abdel‐Fattah, S. A. (2021) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2021.01.008 · Cited by 74 · see citing works
Liehr, T. (2022) · Molecular Cytogenetics · doi:10.1186/s13039-022-00612-2 · Cited by 58 · see citing works
Decision-making factors in prenatal testing: A systematic review
Mattei, V. E. D., Ferrari, F., Perego, G., Tobia, V., Mauro, F., & Candiani, M. (2021) · Health Psychology Open · doi:10.1177/2055102920987455 · Cited by 55 · see citing works
Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review
Labonté, V., Alsaid, D., Lang, B., & Meerpohl, J. J. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2518-x · Cited by 39 · see citing works
Hartwig, T. S., Miltoft, C. B., Malmgren, C. I., Tabor, A., & Jørgensen, F. S. (2019) · Prenatal Diagnosis · doi:10.1002/pd.5476 · Cited by 32 · see citing works
Bowman‐Smart, H., Gyngell, C., Mand, C., Amor, D. J., Delatycki, M. B., & Savulescu, J. (2021) · The American Journal of Bioethics · doi:10.1080/15265161.2021.1996659 · Cited by 28 · see citing works
Decision aids for prenatal testing: A systematic review and meta‐analysis
Yu, L., Yang, S., Zhang, C., Guo, P., Zhang, X., Xu, M., Tian, Q., Cui, X., & Zhang, W. (2021) · Journal of Advanced Nursing · doi:10.1111/jan.14875 · Cited by 20 · see citing works
Yotsumoto, J., Sekizawa, A., Inoue, S., Suzumori, N., Samura, O., Yamada, T., Miura, K., Masuzaki, H., Sawai, H., Murotsuki, J., et al. (2020) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-020-2763-z · Cited by 19 · see citing works
Biesecker, B. B. (2019) · The Hastings Center Report · doi:10.1002/hast.1017 · Cited by 18 · see citing works
Fox, M. M. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.115171 · Cited by 12 · see citing works
YEŞİLÇINAR, İ., Seven, M., Paşalak, Ş. İ., & Güvenç, G. (2021) · Journal of Genetic Counseling · doi:10.1002/jgc4.1437 · Cited by 10 · see citing works
Xiang, J., & Gao, L. (2023) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2023.2232380 · Cited by 9 · see citing works
Hirose, T., 白土, な., Izumi, M., Miyagami, K., & Sekizawa, A. (2020) · Journal of Human Genetics · doi:10.1038/s10038-020-00879-6 · Cited by 8 · see citing works
YEŞİLÇINAR, İ., Şahin, E., & Tutar, S. O. (2024) · Journal of Genetic Counseling · doi:10.1002/jgc4.1951 · Cited by 7 · see citing works
Ternby, E., Axelssön, O., Malmgren, C. I., & Georgsson, S. (2024) · Journal of Community Genetics · doi:10.1007/s12687-024-00746-3 · Cited by 6 · see citing works
Hu, L., Wen, L., Liu, Y., Chen, X., Zhong, J., Liu, W., & Wei, F. (2025) · Prenatal Diagnosis · doi:10.1002/pd.6775 · Cited by 3 · see citing works
Chen, A., Tenhunen, H., Torkki, P. M., Heinonen, S. T., Lillrank, P. M., & Stefanović, V. (2020) · Journal of Perinatal Medicine · doi:10.1515/jpm-2019-0450 · Cited by 3 · see citing works
Xiang, J.-M., Sun, K., Zhao, Q., Li, H.-B., & Gao, L.-L. (2022) · Patient Preference and Adherence · doi:10.2147/ppa.s346017 · Cited by 3 · see citing works
Ternby, E., Axelssön, O., Georgsson, S., & Malmgren, C. I. (2024) · Prenatal Diagnosis · doi:10.1002/pd.6514 · Cited by 3 · see citing works
Ng, V. K., Chan, A. L., Lau, W., & Leung, W. (2020) · Hong Kong Medical Journal · doi:10.12809/hkmj198197 · Cited by 2 · see citing works
Cheung, H. H. C., Tong, L. Y., & To, W. W. K. (2022) · Hong Kong Journal of Gynaecology Obstetrics and Midwifery · doi:10.12809/hkjgom.22.1.02
NIPT: Routine versus Considered Options
Ashutosh, G., Aneja, A., Bahl, N., Arora, R., & Nadir, L. (2024) · Journal of Fetal Medicine · doi:10.1055/s-0045-1808249
- Authors
- Lo, T.-K., Chan, K. Y.-K., Kan, A. S.-Y., So, P.-L., Kong, C.-W., Mak, S.-L., & Lee, C.-N.
- Affiliations
- Princess Margaret Hospital (HK)
- Tsan Yuk Hospital (CN)
- Tuen Mun Hospital (CN)
- United Christian Hospital (CN)
- Queen Elizabeth Hospital (CN)
- Pamela Youde Nethersole Eastern Hospital (CN)
- Corresponding author
- Lo, Tsz-Kin
- Venue
- The Journal of Maternal-Fetal & Neonatal Medicine
- Publisher
- Informa UK Limited
- Published
- 2017-09-19
- Volume
- 32
- Issue
- 2
- Pages
- 348-350
- ISSN
- 1476-4954 (ISSN-L)
- 1476-7058
- OpenAlex
- W2755215193
- Cited by
- 24
- References
- 5
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 5 · 2020: 4 · 2019: 3
- FWCI
- 2.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Maternal-Fetal & Neonatal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- non-invasive prenatal testing, Down syndrome screening, decisional conflict, decision regret, anxiety, prenatal genetic testing, maternal decision-making, pregnant women
- MeSH terms
- Abortion, Induced, Adult, Anxiety, Conflict, Psychological, Decision Making, Down Syndrome, Emotions, Female, Follow-Up Studies, Humans, Pregnancy, Prenatal Diagnosis, Surveys and Questionnaires, Maternal Serum Screening Tests
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