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Non-invasive prenatal testing (NIPT) and pregnant women’s views on good motherhood: a qualitative study

Abstract

Women’s views on responsible motherhood influence decision-making regarding participation in prenatal screening. Previous studies showed that the probabilistic nature of the first-trimester combined test and the potential requirement for subsequent invasive diagnostics serve as legitimate reasons for women to exclude prenatal screening from their moral responsibilities. These moral barriers might now be less relevant with the introduction of the non-invasive prenatal test (NIPT) resulting in women feeling a moral duty to use NIPT screening as part of responsible motherhood. This qualitative study explores the impact of NIPT on women’s moral beliefs about the meaning of prenatal screening in relation to responsible motherhood. We performed semi-structured interviews with 29 pregnant women who were offered NIPT as a first-tier screening test within a Dutch nationwide study (TRIDENT-2). Results show that the inherent uncertainty about the fetus’s health despite improved accuracy and the lack of treatment for a detected disorder, combined with the possibility to obtain information about actionable anomalies through the fetal anomaly scan, support women’s perspectives that NIPT is not an obligation of responsible motherhood. Acceptance of NIPT is considered to be a free decision related to the information each woman needs to be a good mother for her child and her family. Women’s views may change when NIPT has expanded to include treatable or preventable conditions.

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Data availability

The interviews (datasets) generated during and/or analyzed during the current study are not publicly available due them containing information that could compromise research participant privacy/consent, but are available from the corresponding author on reasonable request.

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Acknowledgements

We wish to thank all women and men who participated in this study. We thank the midwifery practices for their help with recruitment, and Elsbeth van Vliet-Lachotzki (VSOP Patient Alliance for Rare and Genetic Diseases) for her feedback on the interview guide and protocol. We thank all members of the Dutch NIPT Consortium (see Supplementary Appendix) for discussion and feedback on this study.

Funding

Supported by a grant from the Netherlands Organization for Health Research and Development (ZonMw, No. 543002001).

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LH, DRMT contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript. They supervised the findings of this work. EG (first author) contributed to the design and implementation of the research. She developed the interview guide, performed some of the interviews and analysed all the interviews together with IK. IK contributed to the development of the interview guide, performed some of the interviews and contributed to the analysis of the results. JTGvdW contributed to the developed of the interview guide and to the analysis of the results. LM and MNB contributed to the developed of the interview guide. All authors discussed the results, provided critical feedback and contributed to the final manuscript.

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Correspondence to Elisa Garcia.

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The authors declare no competing interests.

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Ethical approval for this interview study was obtained from the Medical Ethical Committee of the VU University Medical Center Amsterdam (no. 2017.165 (A2018.069)).

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Garcia, E., Henneman, L., Gitsels-van der Wal, J.T. et al. Non-invasive prenatal testing (NIPT) and pregnant women’s views on good motherhood: a qualitative study. Eur J Hum Genet 30, 669–675 (2022). https://doi.org/10.1038/s41431-021-00945-3

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