title: Attitudes towards non-invasive prenatal diagnosis among obstetricians in Pakistan, a developing, Islamic country.
abstract: OBJECTIVE
  Stakeholders' views are essential for informing implementation strategies for non-invasive prenatal testing (NIPT). Little is known about such views in developing countries. We explored attitudes towards NIPT among obstetricians in Pakistan, a developing, Islamic country.
  
  
  METHODS
  A 35-item questionnaire was distributed and collected at eight events (a national conference and seven workshops in five cities) for obstetric professionals on advances in fetal medicine.
  
  
  RESULTS
  Responses from 113 obstetrician show positive attitudes towards implementation of NIPT: 95% agreed prevention of genetic conditions was a necessity, and 97% agreed public hospitals should provide prenatal screening tests. However, participants also agreed the availability of NIPT would increase social pressure on women to have prenatal screening tests and to terminate an affected pregnancy (53% and 63%, respectively). Most participants would not offer NIPT for sex determination (55%), although 31% would. The most valued aspects of NIPT were its safety, followed by its utility and then accuracy.
  
  
  CONCLUSIONS
  Participants generally supported the implementation of NIPT but raised concerns about social implications. Therefore, national policy is needed to regulate the implementation of NIPT, and pretest information and post-test genetic counselling are needed to mitigate social pressure and support parents to make informed decisions. © 2017 John Wiley & Sons, Ltd.
authors.affiliation: Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, LS2 9NL, UK.
authors.forename: Shenaz
authors.identifier: http://orcid.org/0000-0003-4212-0388
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Genetech Laboratory, Lahore, Pakistan.
authors.forename: Hussain
authors.initials: H
authors.lastname: Jafri
authors.affiliation: Central Park Medical College, Lahore, Pakistan.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Rashid
authors.affiliation: Central Park Medical College, Lahore, Pakistan.
authors.forename: Gerald
authors.initials: G
authors.lastname: Mason
authors.affiliation: Genetech Laboratory, Lahore, Pakistan.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Ehsan
authors.affiliation: Yorkshire Regional Genetics Service, Leeds NHS Teaching Hospitals Trust, Chapel Allerton Hospital, Leeds, LS7 4SA, UK.
authors.forename: Mushtaq
authors.initials: M
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007514:Islam / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009774:Obstetrics / Q000941:ethics; D010154:Pakistan; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000941:ethics / Q000523:psychology / Q000706:statistics & numerical data; D012068:Religion and Medicine; D011795:Surveys and Questionnaires; D000078329:Workforce