title: Uptake of noninvasive prenatal testing (NIPT) in women following positive aneuploidy screening.
abstract: OBJECTIVE
  The aim of this study was to investigate how the introduction of noninvasive prenatal testing (NIPT) impacted women's testing choices following a positive prenatal screening (PNS) result.
  
  
  METHODS
  Beginning in March 2012, women referred to our Prenatal Diagnosis Center following a positive PNS result were offered NIPT or invasive prenatal diagnosis. Rates of invasive testing and declining follow-up were compared with testing decisions the prior year. Differences were compared using t-test and chi-square. Multivariable logistic regression was performed to identify predictors of test choice.
  
  
  RESULTS
  Between March 2012 and February 2013, 398 screen positive women were seen: 156 (39.2%) underwent invasive testing, 157 (39.4%) had NIPT and 84 (21.1%) declined further testing. In the prior year, 638 screen positive patients were seen: 301 (47.2%) had invasive testing and 337 (52.8%) declined. The rate of invasive testing declined significantly (p = 0.012). Moreover, fewer women declined follow-up testing after introduction of NIPT, 21.2% versus 52.8%, p ≤ 0.001. Race/ethnicity and timing of results (first versus second trimester) were predictors of testing choices; payer and maternal age were not.
  
  
  CONCLUSIONS
  The introduction of NIPT resulted in a significant decrease in invasive diagnostic testing. Additionally, fewer women declined further testing when NIPT was available.
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA. schetty@stanford.edu
authors.forename: Shilpa
authors.initials: S
authors.lastname: Chetty
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Garabedian
authors.forename: Mary E
authors.initials: ME
authors.lastname: Norton
mesh_terms: D000328:Adult; D000782:Aneuploidy; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005817:Genetic Counseling / Q000706:statistics & numerical data; D005820:Genetic Testing; D006801:Humans; D010358:Patient Participation / Q000706:statistics & numerical data; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012189:Retrospective Studies