Changes in the attitudes of women who have undergone NIPT toward prenatal testing: The impact of the introduction of the prenatal testing certification system in Japan

Abstract

Aims: We compared changes in the perceptions of non-invasive prenatal testing (NIPT) before and after the introduction of a government-involved NIPT certification system in July 2022. Methods: Web-based surveys of pregnant women who underwent NIPT were conducted in 2020 (pre-certification) and 2023 (post-certification) using a pregnancy-related mobile application. Results: We obtained 1198 and 1227 responses from the 2020 and 2023 surveys, respectively. Compared with 2020 respondents, 2023 respondents who chose non-certified facilities emphasized word-of-mouth reputation, online appointment availability, expanded testing beyond the three major trisomies, low cost, and improved accessibility. The two survey years showed no significant differences in overall trends in facility selection and the tendency to choose certified facilities to prioritize recommendations from their primary care physicians and the availability of pre-test genetic counseling. Additionally, when NIPT results were non-negative, respondents tested at non-certified facilities in 2023 were more likely to report concerns such as “insufficient explanation increased my anxiety” and “I regretted my choice of testing facility.” More respondents in 2023 preferred to undergo NIPT at facilities that provide routine prenatal checkups and believed each pregnant woman should make testing decisions. Conclusions: After introducing the NIPT certification system, those choosing to undergo testing at certified facilities emphasized the importance of comprehensive support, whereas those opting for non-certified facilities prioritized convenience. However, the latter group became increasingly aware of the lack of post-test support when faced with non-negative results.