Korean physicians’ attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

Abstract

Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

<p>The Population Prevalence, Associations of Congenital Heart Defect and Mortality Risk for Down’s Syndrome in South Korea Based on National Health Insurance Service (NHIS) Data</p>

“…In South Korea, maternal serum screening test for fetal aneuploidy in the first trimester has been covered by the NHIS and performed in more than 95% of pregnancies. 17 Whereas, termination of pregnancy including DS pregnancy was designated as a crime and was subject to punishment by criminal law and a physician only to perform a termination in exceptional cases under the Maternal and Child Health law. 18 It is difficult to provide legal data on artificial abortion of DS pregnancy.…”

Informed choice of pregnant women regarding noninvasive prenatal testing in Korea: a cross-sectional study

“…In addition, the role of nurses as advocates is now increasingly emphasized [21]. Although a study attempted to examine the proper clinical applications and nursing implications of NIPT at the initial stage of the introduction of NIPT in Korea [22], since then, only one study has examined healthcare providers' attitudes toward NIPT and its implementation [23]. To our best knowledge, there are yet no studies on pregnant women's NIPT-related experiences in Korea.…”

Review of Prenatal Aneuploidy Screening Uptake Rate and Trends in Iran, and Developed Countries

“…Our survey on fetal health screening in Europe and other developed countries has shown that screening is offered to all pregnant women in Belgium, Denmark, Finland, France, Switzerland, South Korea, etc., and the expenses are reimbursed (11,12). Table 1 shows the uptake rate of prenatal screening in 18 countries.…”