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. 2023 Feb;32(1):213-223.
doi: 10.1002/jgc4.1635. Epub 2022 Sep 16.

Experiences of receiving an increased chance of sex chromosome aneuploidy result from non-invasive prenatal testing in Australia: "A more complicated scenario than what I had ever realized"

Miranda F Lewit-Mendes  1   2 , Hazel Robson  1   3 , Joanne Kelley  4 , Justine Elliott  5   6 , Erica Brown  7 , Melody Menezes  1   8 , Alison D Archibald  1   5   6
Affiliations

Experiences of receiving an increased chance of sex chromosome aneuploidy result from non-invasive prenatal testing in Australia: "A more complicated scenario than what I had ever realized"

Miranda F Lewit-Mendes et al. J Genet Couns. 2023 Feb.

Abstract

Many non-invasive prenatal testing (NIPT) platforms screen for sex chromosome aneuploidy (SCA) and SCA analysis is generally included in Australia where NIPT is available as a self-funded test. Little is known about the experience of receiving an NIPT result indicating an increased chance of SCA. This study aimed to explore the experiences of people who received this result and their perspectives on the information, care, and support they received from healthcare practitioners (HCPs). Semi-structured interviews were conducted with people who received an NIPT result indicating an increased chance of SCA and continued their pregnancy. Most participants only had contact with a genetic counselor after receiving their result. Transcribed data were analyzed using rigorous thematic analysis to identify important patterns and themes. Participants (18 women, 2 male partners) described embarking on NIPT, primarily based on advice from their HCP and without much consideration. Consequently, participants expressed feeling unprepared for the unanticipated complexity of their NIPT result and were faced with making a time-sensitive decision about a condition they had not previously considered. While more pre-test information was desired, timely access to genetic counseling post-test assisted with adjustment to the result. These findings suggest that routinization of NIPT may be compromising informed decision-making, resulting in unpreparedness for an increased chance result. Given the increasing uptake and expanding scope of NIPT, resources should be dedicated to educating HCPs offering NIPT and ensuring timely access to genetic counseling post-result. With appropriate funding, genetics services may be able to play a central role in offering information and support to both people who undertake NIPT and their HCPs ordering the testing. Implementing a publicly funded screening program in Australia could assist with standardizing prenatal screening care pathways and consequently better access to appropriate resources.

Keywords: cell-free DNA screening; decision-making; genetic counseling; genetic counselling; lived experience; non-invasive prenatal screening; non-invasive prenatal testing; sex chromosome aneuploidy.

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References

REFERENCES

    1. Abramsky, L., Hall, S., Levitan, J., & Marteau, T. M. (2001). What parents are told after prenatal diagnosis of a sex chromosome abnormality: Interview and questionnaire study. BMJ, 322(7284), 463-466. https://doi.org/10.1136/bmj.322.7284.463
    1. Audibert, F., De Bie, I., Johnson, J. A., Okun, N., Wilson, R. D., Armour, C., Chitayat, D., & Kim, R. (2017). No. 348-Joint SOGC-CCMG Guideline: Update on prenatal screening for fetal aneuploidy, fetal anomalies, and adverse pregnancy outcomes. Journal of Obstetrics and Gynaecology Canada, 39(9), 805-817. https://doi.org/10.1016/j.jogc.2017.01.032
    1. Bakkeren, I. M., Kater-Kuipers, A., Bunnik, E. M., Go, A., Tibben, A., de Beaufort, I. D., Galjaard, R. H., & Riedijk, S. R. (2020). Implementing non-invasive prenatal testing (NIPT) in The Netherlands: An interview study exploring opinions about and experiences with societal pressure, reimbursement, and an expanding scope. Journal of Genetic Counseling, 29(1), 112-121. https://doi.org/10.1002/jgc4.1188
    1. Bianchi, D. W., Chudova, D., Sehnert, A. J., Bhatt, S., Murray, K., Prosen, T. L., Garber, J. E., Wilkins-Haug, L., Vora, N. L., Warsof, S., Goldberg, J., Ziainia, T., & Halks-Miller, M. (2015). Noninvasive prenatal testing and incidental detection of occult maternal malignancies. JAMA, 314(2), 162-169. https://doi.org/10.1001/jama.2015.7120
    1. Bianchi, D. W., Parsa, S., Bhatt, S., Halks-Miller, M., Kurtzman, K., Sehnert, A. J., & Swanson, A. (2015). Fetal sex chromosome testing by maternal plasma DNA sequencing: Clinical laboratory experience and biology. Obstetrics and Gynecology, 125(2), 375-382. https://doi.org/10.1097/AOG.0000000000000637

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