title: Trial by Dutch laboratories for evaluation of non-invasive prenatal testing. Part II-women's perspectives.
abstract: OBJECTIVE
  To evaluate preferences and decision-making among high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing.
  
  
  METHODS
  Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice.
  
  
  RESULTS
  A total of 1091/1253 (87%) women completed the questionnaire. Of these, 1053 (96.5%) underwent NIPT, 37 (3.4%) invasive testing and 1 (0.1%) declined testing. 91.7% preferred NIPT because of test safety. Overall, 77.9% made an informed choice, 89.8% had sufficient knowledge and 90.5% had positive attitudes towards NIPT. Women with intermediate (odds ratio (OR) = 3.51[1.70-7.22], p < 0.001) or high educational level (OR = 4.36[2.22-8.54], p < 0.001) and women with adequate health literacy (OR = 2.60[1.36-4.95], p = 0.004) were more likely to make an informed choice. Informed choice was associated with less decisional conflict and less anxiety (p < 0.001). Intention to terminate the pregnancy for Down syndrome was higher among women undergoing invasive testing (86.5%) compared to those undergoing NIPT (58.4%) (p < 0.001).
  
  
  CONCLUSIONS
  The majority of women had sufficient knowledge and made an informed choice. Continuous attention for counseling is required, especially for low-educated and less health-literate women. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
authors.affiliation: Department of Clinical Genetics, Section Community Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Rachèl V
authors.initials: RV
authors.lastname: van Schendel
authors.affiliation: Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: G C Lieve
authors.initials: GC
authors.lastname: Page-Christiaens
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Lean
authors.initials: L
authors.lastname: Beulen
authors.affiliation: Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Catia M
authors.initials: CM
authors.lastname: Bilardo
authors.affiliation: Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Marjon A
authors.initials: MA
authors.lastname: de Boer
authors.affiliation: Department of Obstetrics and Gynaecology, Maastricht UMC+, Maastricht, The Netherlands.
authors.forename: Audrey B C
authors.initials: AB
authors.lastname: Coumans
authors.affiliation: Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Brigitte H
authors.initials: BH
authors.lastname: Faas
authors.affiliation: Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Irene M
authors.initials: IM
authors.lastname: van Langen
authors.affiliation: Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Klaske D
authors.initials: KD
authors.lastname: Lichtenbelt
authors.affiliation: Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Merel C
authors.initials: MC
authors.lastname: van Maarle
authors.affiliation: Department of Clinical Genetics, Maastricht UMC+, Maastricht, The Netherlands.
authors.forename: Merryn V E
authors.initials: MV
authors.lastname: Macville
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Dick
authors.initials: D
authors.lastname: Oepkes
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Eva
authors.initials: E
authors.lastname: Pajkrt
authors.affiliation: Department of Clinical Genetics, Section Community Genetics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Lidewij
authors.initials: L
authors.lastname: Henneman
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001294:Attitude to Health; D025063:Chromosome Disorders / Q000175:diagnosis*; D002882:Chromosomes, Human, Pair 13; D002887:Chromosomes, Human, Pair 18; D003220:Conflict, Psychological; D004247:DNA / Q000097:blood*; D003657:Decision Making; D004314:Down Syndrome / Q000175:diagnosis; D004522:Educational Status; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D057220:Health Literacy; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D017422:Sequence Analysis, DNA / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014314:Trisomy / Q000175:diagnosis; D000073839:Trisomy 13 Syndrome; D000073842:Trisomy 18 Syndrome; D055815:Young Adult
chemical_list: D004247:DNA