Non-Invasive Prenatal Screening (Nips) Testing Motivations and Informed Decision Making In The Low-Risk Population

<p>Non-Invasive Prenatal Screening (NIPS) provides a risk assessment for aneuploidies by utilizing cell-free DNA (cfDNA). Recently, it was recommended that NIPS be offered to all pregnant people regardless of a priori risk for aneuploidy. In the absence of an increased risk, alternative motives for electing NIPS, such as for fetal sex disclosure, may arise and result in a less informed decision about proceeding with NIPS. Therefore, our study aimed to characterize low-risk patients’ motivations for NIPS election, compare motivations between informed and uninformed decision makers, and determine whether electing NIPS for fetal sex disclosure had any bearing on informed decision making. A survey that included a validated measure of informed choice (MMIC) and questions to assess patients’ motivations for NIPS was offered at four UTHealth clinics post genetic counseling. It was found that 44% of participants made an uninformed decision about testing. Participants with private insurers were 5.92 times more likely to make an informed decision (95% CI =1.28-33.05), and participants that self-identified as Black were 9.64 times more likely to make an uninformed decision (CI=0.009-0.737). Informed decision makers scored avoiding invasive procedures higher (p= 0.007) and ranked doing what family/friends desire lower (p = 0.0048) than uninformed decision makers. While most participants scored receiving information about genetic conditions highest, 12% of participants reported fetal sex disclosure as a priority. However, this was not found to be associated with uninformed decision making. Instead, prioritizing fetal sex was associated with a younger age (p=0.049) and experience with NIPS in previous pregnancies (p=0.034). This study ultimately established shared motivations with the high-risk population, showed no association between fetal sex disclosure motivation and uninformed decision making, characterized participants prioritizing fetal sex, and emphasized the importance of complete pre-test counseling.</p>

Name thesis:degree_name

Masters of Science (MS)

Level thesis:degree_level

Thesis (MS)

Year dc:date.available

2022

Authors dc:creator

• Lea, Jenna
• <p><strong>0000-0002-2205-5788</strong></p>

Contributors dc:contributor

• Meagan Choates
• Blair Stevens
• Syed Hashmi

• NIPS
• Non-Invasive Prenatal Screening
• NIPT
• Motivations
• Fetal Sex
• Informed Decision Making
• Other Medicine and Health Sciences

Repository record dc:identifier

https://digitalcommons.library.tmc.edu/utgsbs_dissertations/1188

OAI identifier oai:identifier

oai:digitalcommons.library.tmc.edu:utgsbs_dissertations-2241