title: [Analysis of cell-free DNA in maternal blood for detection of fetal trisomy 21 in high-risk population: Couples acceptance and grounds for refusal].
abstract: OBJECTIVE
  To assess the determinants associated with the use of analysis of cell-free DNA in maternal blood for detection of trisomy 21 in high-risk women.
  
  
  METHODS
  Prospective study conducted in a single center between July 15, 2014 and December 15, 2014 on 99 consecutive women with increased risk of trisomy 21 above 1/250.
  
  
  RESULTS
  Analysis of cell-free DNA in maternal blood for detection of fetal trisomy 21 was proposed to 95 women out of 99, among them, 43 women (45.3%) required the test. Among these 43 women, 17 (38.6%) had a higher socio-economic status versus 10 (19.2%) among the women who did not request the test (P=0.03). The most common reason given by the 52 women who did not request the analysis of cell-free DNA was the cost, for 30 of them (57.7%), then because the test was not providing certainty for the diagnostic of trisomy 21 for 23 women (44.2%).
  
  
  CONCLUSIONS
  Analysis of cell-free DNA on maternal blood for detection of trisomy 21 does not seem accepted by the majority of women. The cost is probably the main reason for not using this test, but it seems that the lack of diagnostic certainty is also an obstacle for some women.
authors.affiliation: Maternité Port-Royal, université Paris Descartes, groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; DHU risques et grossesse, PRES Sorbonne Paris Cité, 53, avenue de l'Observatoire, 75014 Paris, France. Electronic address: olivia.anselem@cch.aphp.fr.
authors.forename: O
authors.initials: O
authors.lastname: Anselem
authors.affiliation: Maternité Port-Royal, université Paris Descartes, groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; DHU risques et grossesse, PRES Sorbonne Paris Cité, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Keroui
authors.affiliation: Maternité Port-Royal, université Paris Descartes, groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; DHU risques et grossesse, PRES Sorbonne Paris Cité, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Deput-Rampon
authors.affiliation: Maternité Port-Royal, université Paris Descartes, groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; DHU risques et grossesse, PRES Sorbonne Paris Cité, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Chartier
authors.affiliation: Département de biologie spécialisée et de génétique, laboratoire Cerba, 95310 Saint-Ouen l'Aumône, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Costa
authors.affiliation: Maternité Port-Royal, université Paris Descartes, groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; DHU risques et grossesse, PRES Sorbonne Paris Cité, 53, avenue de l'Observatoire, 75014 Paris, France; Unité Inserm U953, recherche épidémiologique en santé périnatale et santé des femmes et des enfants, UPMC, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Goffinet
authors.affiliation: Maternité Port-Royal, université Paris Descartes, groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; DHU risques et grossesse, PRES Sorbonne Paris Cité, 53, avenue de l'Observatoire, 75014 Paris, France; Unité Inserm U953, recherche épidémiologique en santé périnatale et santé des femmes et des enfants, UPMC, 53, avenue de l'Observatoire, 75014 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Tsatsaris
mesh_terms: D000328:Adult; D004314:Down Syndrome / Q000175:diagnosis*; D005260:Female; D006801:Humans; D062145:Maternal Serum Screening Tests / Q000191:economics* / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D012306:Risk; D017422:Sequence Analysis, DNA
keywords: ADN fœtal circulant; Cell-free DNA; Diagnostic prénatal non invasif; Non-invasive prenatal testing; Trisomie 21; Trisomy 21