Changing to NIPT as a first-tier screening test and future perspectives: Opinions of health professionals

Abstract

Objective: The aim of this study was to investigate health professionals' opinions toward offering noninvasive prenatal testing (NIPT) as first-tier screening test regardless of pregnant women's risk, and toward a potential broader range of disorders. Methods: A questionnaire completed by obstetric health professionals (n=240) after an in-service NIPT training in the West and North of the Netherlands. Results: The majority (72%) of respondents favored replacing first-trimester combined test (FCT) by NIPT, although 43% preferred to maintain nuchal translucency measurement. Many respondents believed that replacing FCT by NIPT would only have advantages (57%), would lead to more pregnant women opting for prenatal testing (69%), and would simplify counseling (47%). Differences in attitudes toward counseling between health professionals were observed. When considering NIPT to screen for broader range of disorders, the majority (92%) thought that this should include disorders characterized by neonatal death, whereas 52% of the respondents favored testing for fetomaternal risk factors. Overall, 46% thought screening should be offered as a fixed list of disorders. Conclusion: Most health professionals favor NIPT instead of FCT but prefer to maintain nuchal translucency measurement. If NIPT becomes available as a first-tier screening test, attention remains necessary to ensure that pregnant women make well-informed decisions in line with the aim of prenatal screening. What's already known about this topic? Noninvasive prenatal testing (NIPT) for aneuploidy screening has high accuracy regardless of pregnant women's risk. Maternal plasma contains the entire fetal genome, potentially widening the scope of NIPT. What does this study add? Health professionals favor offering NIPT to all women; most want to maintain nuchal fold measurement. The majority (92%) of health professionals thought NIPT-based screening should include disorders characterized by neonatal death or death within the first year of life; 52% favored testing for fetomaternal risk factors. Most health professionals thought that a broader range of disorders should be offered as a 'fixed list of disorders' in contrast to pregnant women who mostly preferred to have a free choice.