Change in rates of prenatal tests for chromosomal abnormality over a 12-year period in women of advanced maternal age
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Objective In 2007, the American College of Obstetricians and Gynecologists (ACOG) recommended that all pregnant womenbe offered screening or diagnostic tests for chromosomal abnormalities regardless of their age. Noninvasive prenataltesting (NIPT) for common chromosomal aneuploidies was introduced as a screening test in case of high-riskpregnancies. We assessed the rates of prenatal tests in women aged 35 years and older. Methods A retrospective study was conducted to compare the rates of amniocentesis, chorionic villus sampling (CVS), serumscreening, and NIPT from January 2005 through March 2017 in women aged 35 years and older. We divided the initial12 months after NIPT introduction into 4-month intervals, beginning in April 2016 through March 2017. Results The rates of amniocentesis were 56% before the ACOG statement, 38% between the ACOG statement and NIPTintroduction, and 10% after NIPT introduction (P=0.001). The rates of CVS during the same periods were 0.5%, 2.1%,and 4.3% (P=0.016), respectively. The rates of serum screening were 44.2%, 61.3%, and 55.1% (P=0.049), respectively. During the 3 quarters after NIPT introduction, the rates of amniocentesis were 16.2%, 12.3%, and 7.3% (P=0.002),respectively; the rates of serum screening were 62%, 54%, and 46% (P=0.03), respectively; and the rates of NIPTwere 19.9%, 30.3%, and 39.5% (P=0.007), respectively. The rates of CVS over the same periods were not significantlydifferent. Conclusion The ACOG statement and NIPT introduction significantly decreased the rate of amniocentesis in women of advancedmaternal age. NIPT also reduced the rate of serum screening.
Abstract
Objective In 2007, the American College of Obstetricians and Gynecologists (ACOG) recommended that all pregnant womenbe offered screening or diagnostic tests for chromosomal abnormalities regardless of their age. Noninvasive prenataltesting (NIPT) for common chromosomal aneuploidies was introduced as a screening test in case of high-riskpregnancies. We assessed the rates of prenatal tests in women aged 35 years and older. Methods A retrospective study was conducted to compare the rates of amniocentesis, chorionic villus sampling (CVS), serumscreening, and NIPT from January 2005 through March 2017 in women aged 35 years and older. We divided the initial12 months after NIPT introduction into 4-month intervals, beginning in April 2016 through March 2017. Results The rates of amniocentesis were 56% before the ACOG statement, 38% between the ACOG statement and NIPTintroduction, and 10% after NIPT introduction (P=0.001). The rates of CVS during the same periods were 0.5%, 2.1%,and 4.3% (P=0.016), respectively. The rates of serum screening were 44.2%, 61.3%, and 55.1% (P=0.049), respectively. During the 3 quarters after NIPT introduction, the rates of amniocentesis were 16.2%, 12.3%, and 7.3% (P=0.002),respectively; the rates of serum screening were 62%, 54%, and 46% (P=0.03), respectively; and the rates of NIPTwere 19.9%, 30.3%, and 39.5% (P=0.007), respectively. The rates of CVS over the same periods were not significantlydifferent. Conclusion The ACOG statement and NIPT introduction significantly decreased the rate of amniocentesis in women of advancedmaternal age. NIPT also reduced the rate of serum screening.
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