Perspectives of Pregnant People and Clinicians on Noninvasive Prenatal Testing: A Systematic Review and Qualitative Meta-synthesis

Vanstone M, Cernat A, Majid U, Trivedi F, De Freitas C
Record ID 32018000451
English
Authors' objectives: To determine the perspectives, experiences, and preferences of pregnant people, their families, clinicians, and others with rich lived experiences of noninvasive prenatal testing (NIPT).
Authors' results and conclusions: Results Most people (pregnant people, clinicians, and others with relevant lived experience) said that NIPT offered important information to pregnant people and their partners. Most people were very enthusiastic about widening access to NIPT because it can provide information about chromosomal anomalies quite early in pregnancy, with relatively high accuracy, and without risk of procedure-related pregnancy loss. However, many groups cautioned that widening access to NIPT may result in routinization of this test, causing potential harm to pregnant people, their families, the health care system, people living with disabilities, and society as a whole. Widened logistical, financial, emotional, and informational access may be perceived as a benefit, but it can also confer harm on various groups. Many of these challenges echo historical critiques of other forms of prenatal testing, with some issues mitigated or exacerbated by the particular features of NIPT. Conclusions Noninvasive prenatal testing offers significant benefit for pregnant people but may also be associated with potential harms related to informed decision-making, inequitable use, social pressure to test, and reduced support for people with disabilities.
Authors' methods: We performed a systematic review of primary, empirical qualitative research that describes the experiences and perspectives of pregnant people, their families, clinicians, and others with lived experience relevant to NIPT. We were interested in the beliefs, experiences, preferences, and perspectives of these groups. We analyzed the evidence available in 36 qualitative and mixed-methods studies using the integrative technique of qualitative meta-synthesis.
Details
Project Status: Completed
Year Published: 2019
URL for published report: https://www.hqontario.ca/Portals/0/documents/evidence/reports/qualrep-noninvasive-prenatal-testing.pdf
Requestor: Ontario Health Technology Advisory Committee (OHTAC); Ontario Ministry of Health
URL for additional information: https://www.hqontario.ca/evidence-to-improve-care/health-technology-assessment/reviews-and-recommendations/noninvasive-prenatal-testing-for-trisomies-21-18-and-13-sex-chromosome-aneuploidies-and-microdeletions
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Canada
Province: Ontario
Pubmed ID: 30838086
MeSH Terms
  • Patient Acceptance of Health Care
  • Patient Preference
  • Patient Satisfaction
  • Prenatal Diagnosis
  • Pregnancy
  • Qualitative Research
  • Congenital Abnormalities
  • Congenital, Hereditary, and Neonatal Diseases and Abnormalities
  • Attitude of Health Personnel
Keywords
  • Noninvasive Prenatal Testing
  • patient experiences
  • patient attitides
  • chromosomal anomalies
  • decision-making
  • pregnancy
  • early diagnosis
  • patient satisfaction
  • patient preferences
Contact
Organisation Name: Health Quality Ontario
Contact Address: Evidence Development and Standards, Health Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, Ontario Canada M5S 1N5
Contact Name: EDSinfo@hqontario.ca
Contact Email: OH-HQO_hta-reg@ontariohealth.ca
Copyright: Health Quality Ontario
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.