Abstract
Objective: To investigate factors involved in the decision to decline prenatal screening with noninvasive prenatal testing (NIPT).
Method: A questionnaire study was conducted among 219 pregnant women in the Netherlands who had declined prenatal screening with NIPT (TRIDENT‐2 study). Respondents were selectively recruited from three hospitals and 19 midwifery practices, primarily located in or near socioeconomically disadvantaged neighborhoods. 44.3% of the respondents were of non‐Western ethnic origin and 64.4% were religious.
Results: Most respondents (77.2%) found the decision to decline NIPT easy to make, and 59.8% had already made the decision before information about NIPT was offered. These respondents were more often religious, multigravida, and had adequate health literacy. The main reasons to decline NIPT were “I would never terminate my Lisanne van Prooyen Schuurman and Karuna van der Meij contributed equally to this work. A complete list of all members of the Dutch NIPT Consortium is provided in Appendix 1. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. © 2022 The Authors. Prenatal Diagnosis Prenatal Diagnosis. 2023;43:467–476. wileyonlinelibrary.com/journal/pd – 467 pregnancy” (57.1%) and “every child is welcome” (56.2%). For 16.9% of respondents, the out‐of‐pocket costs (175 euros) played a role in the decision, and the women in this group were more often nonreligious, primigravida, and had inadequate health literacy.
Conclusion: The primary factors involved in the decision to decline NIPT were related to personal values and beliefs, consistent with autonomous choice. Out‐of‐ pocket costs of NIPT hinder equal access for some pregnant women. Key points What’s already known about this topic? Women with low education levels and/or low income levels are less likely to opt for prenatal screening. Differences in screening uptake based on socioeconomic factors might indicate unequal access to prenatal screening. What does this study add? Personal beliefs and values play a prominent role in the decision to decline noninvasive prenatal testing (NIPT), which is in accordance with autonomous choice. The out‐of‐pocket costs play a role in the decision to decline NIPT in 16.9% of respondents. 1 |