title: Chromosomal microarray use among women undergoing invasive prenatal diagnosis.
abstract: OBJECTIVE
  To study the offer and uptake of chromosomal microarray analysis (CMA) among women undergoing invasive prenatal testing.
  
  
  METHODS
  This is a retrospective cohort study of women who underwent chorionic villus sampling (CVS) or amniocentesis. Charts were reviewed for CMA offer and uptake, in additional to clinical and demographic variables.
  
  
  RESULTS
  One hundred forty-one women underwent CVS (n = 53) or amniocentesis (n = 91) over the study period. Overall, 41% of women underwent CMA. Women who underwent invasive testing for a fetal structural abnormality were more likely to undergo CMA than women who underwent invasive testing for all other indications (aOR 43.18, 95% CI 4.64 - 401.58). Chromosomal microarray was offered more often to women who primarily spoke English (p < 0.001), self-identified as white (p = 0.046) and did not receive prenatal care in a community health center (p = 0.044). Statistically significant differences in CMA uptake by race/ethnicity, language, insurance or provider type were not noted. Multiparous women were less likely to accept this test than nulliparas (aOR 0.39, 95% CI 0.17 - 0.86).
  
  
  CONCLUSIONS
  Women who undergo invasive fetal testing are more likely to undergo CMA if the indication is for a fetal structural anomaly. There may be important demographic disparities in the offering of CMA which bear further exploration. © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Mariam
authors.initials: M
authors.lastname: Naqvi
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Ilona T
authors.initials: IT
authors.lastname: Goldfarb
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Kaitlin J
authors.initials: KJ
authors.lastname: Hanmer
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Bryant
mesh_terms: D000328:Adult; D000649:Amniocentesis; D015193:Chorionic Villi Sampling; D025063:Chromosome Disorders / Q000175:diagnosis*; D015331:Cohort Studies; D003151:Community Health Centers; D005006:Ethnicity; D005260:Female; D006801:Humans; D007802:Language; D016015:Logistic Models; D008423:Maternal Age; D046228:Microarray Analysis / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D044465:White People