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. 2021 Nov;47(11):3813-3820.
doi: 10.1111/jog.15010. Epub 2021 Sep 6.

Attitude changes toward prenatal testing among women with twin pregnancies after the introduction of noninvasive prenatal testing: A single-center study in Japan

Masanobu Ogawa  1   2 , Yasuyuki Hasuo  1   3   4 , Yumiko Taura  1   3   4 , Ryosuke Tsunematsu  5 , Sawako Shikada  2 , Yuki Matsushita  1   4   6 , Kazuo Sato  1   6
Affiliations

Attitude changes toward prenatal testing among women with twin pregnancies after the introduction of noninvasive prenatal testing: A single-center study in Japan

Masanobu Ogawa et al. J Obstet Gynaecol Res. 2021 Nov.

Abstract

Aim: This study aimed to evaluate changes in prenatal testing among women with twin pregnancies before and after the introduction of noninvasive prenatal testing (NIPT). To date, no consensus on prenatal testing for twin pregnancies has been reached in Japan.

Methods: Women pregnant with twins who requested prenatal testing at Kyushu Medical Center from 2005 to 2018 were included in this study. Genetic counseling was provided to all participants. Their chosen methods of testing were collected and classified as invasive diagnosis (ID), noninvasive screening (NIS), and no test requested (NR). Parity, chorionicity, and methods of conception were assessed as attributes. The study period was divided into three terms according to testing availability in our center.

Results: After NIPT was introduced in our center, the use of ID methods decreased and eventually disappeared while NIS came to the forefront. NR was also the preferred choice of women with twin pregnancies before the introduction of NIPT and decreased but did not disappear after introducing NIPT. Women with twin pregnancies who underwent assisted reproduction initially showed hesitation to undergo testing but showed a strong preference for NIS after the introduction of NIPT. Differences in choice according to parity, chorionicity, and methods of conception were found before the introduction of NIPT but disappeared after introducing NIPT.

Conclusion: Increasing information about NIPT has apparently influenced the attitudes of women with twin pregnancies to prenatal testing in Japan. In particular, those who conceive through assisted reproductive technologies exhibited a strong preference for NIPT.

Keywords: 2.213 genetic counseling; 2.313 serum screening for aneuploidy and anomalies; 2.317 genetic amniocentesis; 2.512 multiple gestation; 4.125 assisted reproductive technology; clinical.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Mosaic plot of distributions of prenatal tests selected by women with twin pregnancies after GC in each term. Numbers in the columns indicate numbers of subjects. Distributions of selected prenatal tests by women with twin pregnancies were significantly different between Term A and Term B, and between Term A and Term C. Comparing NR versus “any test” (NIS + ID), a significant difference was observed only between Term A and Term C (p < 0.05). ns: GC, genetic counseling; ID, invasive diagnosis; NIS, noninvasive screening; NR, no test requested; NS, No significant difference
FIGURE 2
FIGURE 2
Mosaic plot of prenatal tests selected according to different attributes. Numbers in the columns indicate numbers of subjects. (a) Parity distributions of selected prenatal tests by nulliparous women are significantly different between Term A and Term B + C, while those by multiparous women are not. (b) Chorionicity distributions of selected prenatal tests by women with DD pregnancies are significantly different between Team A and Term B + C, while those by women with MD pregnancies are not. (c) Method of conception distributions of selected prenatal tests by women undergoing ART are significantly different between Term A and Term B + C, while those by women conceiving naturally are not. (d) Maternal age: no significant differences are observed in the distributions of the selected prenatal tests by women <35 years old or those of AMA. No significant differences are observed in the distributions of the selected prenatal tests, per attribute, between terms. AMA, advanced maternal age (35 years and older); ART, assisted reproductive technologies; DD, dichorionic diamniotic; MD, monochorionic diamniotic
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