Women's Experience with Non-Invasive Prenatal Testing and Emotional Well-being and Satisfaction after Test-Results

Abstract

Increasingly, high-risk pregnant women opt for non-invasive prenatal testing (NIPT) instead of invasive diagnostic testing. Since NIPT is less accurate than invasive testing, a normal NIPT result might leave women less reassured. A questionnaire study was performed among pregnant women with elevated risk for fetal aneuploidy based on first-trimester combined test (risk ≥1:200) or medical history, who were offered NIPT in the nationwide Dutch TRIDENT study. Pre- and post-test questionnaires (n = 682) included measures on: experiences with NIPT procedure, feelings of reassurance, anxiety (State-Trait Anxiety Inventory, STAI), child-related anxiety (PRAQ-R), and satisfaction. The majority (96.1%) were glad to have been offered NIPT. Most (68.5%) perceived the waiting time for NIPT results (mean: 15 days, range 5-32) as (much) too long. Most women with a normal NIPT result felt reassured (80.9%) or somewhat reassured (15.7%). Levels of anxiety and child-related anxiety were significantly lower after receiving a normal NIPT result as compared to the moment of intake (p < 0.001). Women with inadequate health literacy or a medical history (e.g. previous child with trisomy) experienced significantly higher post-test-result anxiety (Mean (M) STAI = 31.6 and 30.0, respectively) compared to those with adequate health literacy (M = 28.6) and no medical history (M = 28.6), indicating these women might benefit from extra information and/or guidance when communicating NIPT test-results. Introducing NIPT as an alternative to invasive testing, led to an offer that satisfied and largely reassured high-risk pregnant women.

Keywords: Anxiety; NIPT; Non-invasive Prenatal Testing; Prenatal Screening; Reassurance; Satisfaction.

Fig. 1

Women’s feelings towards the time waiting for NIPT results, N = 682

Fig. 2

a Mean STAI scores at intake (Q1) and after receiving a normal NIPT test-result (Q2), N = 656. *Total STAI score (range 20–80). b Mean PRAQ-R scores at intake (Q1) and after receiving a normal NIPT test-result (Q2), N = 653. *Total PRAQ-R score calculated with subscale ‘child-related anxiety’ (range 4–20)