title: Patient acceptance of non-invasive testing for fetal aneuploidy via cell-free fetal DNA.
abstract: OBJECTIVE
  To evaluate factors associated with patient acceptance of noninvasive prenatal testing for trisomy 21, 18 and 13 via cell-free fetal DNA.
  
  
  METHODS
  This was a retrospective study of all patients who were offered noninvasive prenatal testing at a single institution from 1 March 2012 to 2 July 2012. Patients were identified through our perinatal ultrasound database; demographic information, testing indication and insurance coverage were compared between patients who accepted the test and those who declined. Parametric and nonparametric tests were used as appropriate. Significant variables were assessed using multivariate logistic regression. The value p < 0.05 was considered significant.
  
  
  RESULTS
  Two hundred thirty-five patients were offered noninvasive prenatal testing. Ninety-three patients (40%) accepted testing and 142 (60%) declined. Women who accepted noninvasive prenatal testing were more commonly white, had private insurance and had more than one testing indication. There was no statistical difference in the number or the type of testing indications. Multivariable logistic regression analysis was then used to assess individual variables. After controlling for race, patients with public insurance were 83% less likely to accept noninvasive prenatal testing than those with private insurance (3% vs. 97%, adjusted RR 0.17, 95% CI 0.05-0.62).
  
  
  CONCLUSIONS
  In our population, having public insurance was the factor most strongly associated with declining noninvasive prenatal testing.
authors.affiliation: Department of Obstetrics and Gynecology, Winthrop University Hospital, Mineola, and Stony Brook University Medical Center , Stony Brook, NY , USA.
authors.forename: Sevan A
authors.initials: SA
authors.lastname: Vahanian
authors.forename: M
authors.initials: M
authors.lastname: Baraa Allaf
authors.forename: Corinne
authors.initials: C
authors.lastname: Yeh
authors.forename: Martin R
authors.initials: MR
authors.lastname: Chavez
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Kinzler
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Vintzileos
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004247:DNA / Q000097:blood* / Q000302:isolation & purification; D005260:Female; D005820:Genetic Testing / Q000379:methods*; D006279:Health Maintenance Organizations; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008431:Maternal-Fetal Exchange; D008484:Medicaid / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D011243:Preferred Provider Organizations; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D012189:Retrospective Studies; D014314:Trisomy / Q000175:diagnosis* / Q000235:genetics; D014481:United States
chemical_list: D004247:DNA