title: Spanish- and English-Speaking Pregnant Women's Views on cfDNA and Other Prenatal Screening: Practical and Ethical Reflections.
abstract: The rapid clinical implementation of cell-free DNA (cfDNA) screening, a non-invasive method of prenatal genetic screening, has outpaced research on its social and ethical implications. This study is the first to compare the ethical and practical views of Spanish- and English-speaking pregnant women in the United States about cfDNA screening. Semi-structured interviews were conducted with diverse Spanish- and English-speaking women who had received prenatal care at a large academic medical center. Of the 24 interviewees, ten were Latinas who were interviewed in Spanish; English-language interviews were conducted with seven non-Hispanic Asian and seven non-Hispanic White women. Participants held positive opinions concerning the accuracy of cfDNA screening and often noted that it would enhance preparedness. Participants also expressed concerns about the possibility of inaccurate results and the potentially negative effects of cfDNA screening on the experience of pregnancy. Differences emerged between Spanish and English speakers in their portrayals of their relationships with prenatal health care providers, the extent to which they questioned providers' advice, their ethical concerns, and their informational needs. We emphasize the importance of customizing prenatal test counseling to the needs of the individual patient, providing educationally appropriate counseling and literature, and mitigating potential language barriers.
authors.affiliation: Geisel School of Medicine, Dartmouth College, Hanover, NH, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Floyd
authors.affiliation: Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Allyse
authors.affiliation: UCSF Institute for Health and Aging, University of San Francisco, 3333 California St, Box 0646, San Francisco, CA, 94118, USA. marsha.michie@ucsf.edu.
authors.forename: Marsha
authors.initials: M
authors.lastname: Michie
mesh_terms: D000293:Adolescent; D000328:Adult; D003144:Communication Barriers; D005260:Female; D005817:Genetic Counseling / Q000941:ethics / Q000523:psychology*; D005820:Genetic Testing; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007802:Language; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000941:ethics / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: Ethics; Latinas; NIPS; NIPT; Prenatal screening; Spanish-speakers; cfDNA; cfDNA screening