Attitudes and Knowledge of Maternal‐Fetal Medicine Fellows Regarding Noninvasive Prenatal Testing

Swaney, Paul; Hardisty, Emily; Sayres, Lauren; Wiegand, Samantha; Vora, Neeta L.

doi:10.1007/s10897-015-9844-6

Cited by 14 publications

(10 citation statements)

References 14 publications

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“…This is in keeping with previous findings where even within a group of only USA-based MFM Fellows, the accuracy of a MFM fellow’s knowledge regarding possible indications for cfDNA screening trended towards higher levels with increasing year in the MFM fellowship [ 20 ]. As a whole, the majority of our Canadian participants demonstrated support towards use of cfDNA screening, a similar finding to attitudes of healthcare providers found in other countries like the USA, United Kingdom, Netherlands, and China [ 11 , 20 – 22 ]. However, we discovered that MFM and OB/GYN demonstrated significantly more support towards the use of cfDNA screening than GP and MW.…”

Section: Discussionsupporting

confidence: 90%

“…Our study has certain limitations. We achieved a response rate of only 15.9%, a smaller response to similar studies performed where physician response rates were approximately 35–42% [ 11 , 18 , 20 , 29 ]. However, despite the lower response rate, we achieved higher absolute numbers of respondents ( n = 207) than many other studies previously performed in the subject.…”

Section: Discussionmentioning

confidence: 68%

“…Similar studies assessing Obstetricians/Gynecologists completed 1 year after commercial availability in the U.S. found that 32% of respondents had already incorporated cfDNA screening into their practice, and an additional 22% were familiar with published clinical data, while 8% had never heard of this type of technology [ 19 ]. A study looking at the attitudes and knowledge of MFM Fellows in the U.S. regarding cfDNA screening found that > 75% are comfortable ordering the test [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Obstetrical provider knowledge and attitudes towards cell–free DNA screening: results of a cross-sectional national survey

Chan

Johnson

Wilson

et al. 2018

BMC Pregnancy Childbirth

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BackgroundCell-free DNA (cfDNA) screening has recently acquired tremendous attention, promising patients and healthcare providers a more accurate prenatal screen for aneuploidy than other current screening modalities. It is unclear how much knowledge regarding cfDNA screening obstetrical providers possess which has important implications for the quality and content of the informed consent patients receive.MethodsA survey was designed to assess obstetrical provider knowledge and attitudes towards cfDNA screening and distributed online through the Society of Obstetricians & Gynecologists of Canada (SOGC). Chi-squared tests were used to detect differences in knowledge and attitudes between groups.Results207 respondents completed the survey, composed of 60.6% Obstetricians/Gynecologists (OB/GYN), 15.4% Maternal Fetal Medicine (MFM) specialists, 16.5% General Practitioners (GP), and 7.5% Midwives (MW). MFM demonstrated a significant trend of being most knowledgeable about cfDNA screening followed by OB/GYN, GP, and lastly MW in almost all aspects of cfDNA screening. All groups demonstrated an overall positive attitude towards cfDNA screening; however, OB/GYN and MFM demonstrated a significantly more positive attitude than GP and MW. Despite not yet being a diagnostic test, 19.4% of GP would offer termination of pregnancy immediately following a positive cfDNA screen result compared to none of the MFM and only few OB/GYN or MW.ConclusionsWe have demonstrated that different types of obstetrical providers possess varying amounts of knowledge regarding cfDNA screening with MFM currently having greater knowledge to all other groups. All obstetrical providers must have adequate prenatal screening understanding so that we can embrace the benefits of this novel and promising technology while protecting the integrity of the informed consent process.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1662-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Obstetrical provider knowledge and attitudes towards cell–free DNA screening: results of a cross-sectional national survey

Chan

Johnson

Wilson

et al. 2018

BMC Pregnancy Childbirth

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“…It is well recognised that in addition to the clinical validity of NIPT, its implementation into public maternity services and the development of national/local guidelines should be based on key stakeholders’ views, particularly ethical, legal and social implication (ELSI) [ 12 ]. There is much research on stakeholders’ views [ 13 , 14 ], generally showing that health professionals have a positive attitude towards implementing NIPT, but also some important ethical concerns and diverse views about how it should be implemented. For example, an American study among obstetricians reported diverse views about whether NIPT should be implemented as a primary or secondary screening test, and whether it should be offered to all or high-risk women [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Obstetric professionals’ perceptions of non-invasive prenatal testing for Down syndrome: clinical usefulness compared with existing tests and ethical implications

Ngan

Wong

et al. 2017

BMC Pregnancy Childbirth

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BackgroundWhile non-invasive prenatal testing (NIPT) for fetal aneuploidy is commercially available in many countries, little is known about how obstetric professionals in non-Western populations perceive the clinical usefulness of NIPT in comparison with existing first-trimester combined screening (FTS) for Down syndrome (DS) or invasive prenatal diagnosis (IPD), or perceptions of their ethical concerns arising from the use of NIPT.MethodsA cross-sectional survey among 327 obstetric professionals (237 midwives, 90 obstetricians) in Hong Kong.ResultsCompared to FTS, NIPT was believed to: provide more psychological benefits and enable earlier consideration of termination of pregnancy. Compared to IPD, NIPT was believed to: provide less psychological stress for high-risk women and more psychological assurance for low-risk women, and offer an advantage to detect chromosomal abnormalities earlier. Significant differences in perceived clinical usefulness were found by profession and healthcare sector: (1) obstetricians reported more certain views towards the usefulness of NIPT than midwives and (2) professionals in the public sector perceived less usefulness of NIPT than the private sector. Beliefs about earlier detection of DS using NIPT were associated with ethical concerns about increasing abortion. Participants believing that NIPT provided psychological assurance among low-risk women were less likely to be concerned about ethical issues relating to informed decision-making and pre-test consultation for NIPT.ConclusionsOur findings suggest the need for political debate initially on how to ensure pregnant women accessing public services are informed about commercially available more advanced technology, but also on the potential implementation of NIPT within public services to improve access and equity to DS screening services.

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“…Seventy‐five percent of participants thought it should be offered universally, although the percentage of those concerned about the use of NIPT for sex determination had increased significantly since a similar survey in 2015 from 1% to 26.5% . In another study from the United States, a 2016 survey of maternal‐fetal medicine fellows, 54.4% of respondents believed that it was somewhat or very likely that NIPT would lead to an increase in sex‐selective TOP . Research from 2016 into the views of Pakistani obstetricians found that 55% would not offer NIPT for sex determination.…”

Section: Nipt Sex Determination and Sex Selectionmentioning

confidence: 99%

Sex selection and non‐invasive prenatal testing: A review of current practices, evidence, and ethical issues

et al. 2019

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Non‐invasive prenatal testing (NIPT) can determine the sex of the fetus very accurately and very early in gestation. There are concerns that the ease, timing, and accuracy of NIPT sex determination will facilitate sex‐selective termination of pregnancy (TOP). Here, we review current practices, the evidence for a link between NIPT and sex‐selective TOP, and associated ethical issues. Sex‐selective TOP, usually motivated by son preference, has had serious demographic consequences in countries such as India and China. Currently, ultrasound is the primary method by which parents determine the sex of the fetus. The diffusion of ultrasound technology has had a direct impact on the rates of sex‐selective TOP. Although NIPT is currently more costly, it is feasible that increased uptake of this technology could have a similar effect. Partly because NIPT is a relatively recent development in prenatal screening, there is little data on the impact of NIPT on sex selection practices. Evidence that NIPT is playing a role in sex‐selective TOP remains largely anecdotal. Further research is required to assess and quantify TOP resulting from NIPT sex determination. The use of these technologies for sex selection raises a number of ethical issues, in addition to practical demographic consequences.

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Attitudes and Knowledge of Maternal‐Fetal Medicine Fellows Regarding Noninvasive Prenatal Testing

Cited by 14 publications

References 14 publications

Obstetrical provider knowledge and attitudes towards cell–free DNA screening: results of a cross-sectional national survey

Obstetrical provider knowledge and attitudes towards cell–free DNA screening: results of a cross-sectional national survey

Obstetric professionals’ perceptions of non-invasive prenatal testing for Down syndrome: clinical usefulness compared with existing tests and ethical implications

Sex selection and non‐invasive prenatal testing: A review of current practices, evidence, and ethical issues

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