Objective
Noninvasive prenatal testing (NIPT) is a recently developed risk-assessment technique
with high sensitivity and specificity for fetal aneuploidy. The effect NIPT has had
on traditional screening and diagnostic testing has not been clearly demonstrated.
In this study, NIPT uptake and subsequent changes in the utilization of first-trimester
screen (FTS), chorionic villus sampling (CVS), and amniocentesis in a single referral
center is reported.
Study Design
Monthly numbers of NIPT (in high-risk patients), FTS, CVS, and amniocentesis were
compared between a 35-month baseline period (April 2009 through February 2012) before
introduction of NIPT, and the initial 16 months following NIPT introduction divided
in 4-month quarters beginning in March 2012 through June 2013.
Results
A total of 1265 NIPT, 6637 FTS, 251 CVS, and 1134 amniocentesis were recorded over
the 51-month study period in singleton pregnancies of women who desired prenatal screening
and diagnostic testing. NIPT became the predominant FTS method by the second quarter
following its introduction, increasing by 55.0% over the course of the study period.
Total first-trimester risk assessments (NIPT+FTS) were not statistically different
following NIPT (P = .312), but average monthly FTS procedures significantly decreased following NIPT
introduction, decreasing by 48.7% over the course of the study period. Average monthly
CVS and amniocentesis procedures significantly decreased following NIPT introduction,
representing a 77.2% and 52.5% decrease in testing, respectively. Screening and testing
per 100 morphological ultrasounds followed a similar trend.
Conclusion
NIPT was quickly adopted by our high-risk patient population, and significantly decreased
alternate prenatal screening and diagnostic testing in a short period of time.
Key words
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Article Info
Publication History
Published online: June 19, 2014
Accepted:
June 17,
2014
Received in revised form:
May 21,
2014
Received:
April 7,
2014
Footnotes
A.Z.A. reports personal fees from Illuminia-Verinata Medical Advisory Board within the past 3 years outside the submitted work. The remaining authors report no conflict of interest.
Cite this article as: Larion S, Warsof SL, Romary L, et al. Uptake of noninvasive prenatal testing at a large academic referral center. Am J Obstet Gynecol 2014;211:651.e1-7.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
