Non-invasive prenatal test uptake in socioeconomically disadvantaged neighborhoods

Dutch NIPT Consortium, Karuna R.M. van der Meij, Caroline Kooij, Mireille N. Bekker, Robert Jan H. Galjaard, Lidewij Henneman*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)
20 Downloads (Pure)

Abstract

Objective: Non-Invasive Prenatal Testing (NIPT) is increasingly being implemented worldwide. In public health programs, equitable access to healthcare is a fundamental principle which also applies to fetal aneuploidy screening. However, the out-of-pocket costs of NIPT may lead to sociodemographic disparities in uptake of screening. This study assessed whether there is a difference in the uptake of NIPT in socioeconomically disadvantaged neighborhoods compared to all other neighborhoods in the Netherlands, where NIPT is implemented in a national screening program (TRIDENT-2 study). Method: NIPT uptake, postal code and age of 156,562 pregnant women who received pre-test counselling for prenatal screening in 2018 were retrieved from the national prenatal screening database. Postal codes were used as a proxy to categorize neighborhoods as being either socioeconomically disadvantaged or other. The out-of-pocket costs for NIPT were €175. Results: NIPT uptake in socioeconomically disadvantaged neighborhoods was 20.3% whereas uptake in all other neighborhoods was 47.6% (p < 0.001). The difference in NIPT uptake between socioeconomic disadvantaged neighborhoods and other areas was smaller for the youngest maternal age-group (≤25 years) compared to other age-groups. Conclusion: The variation in uptake suggest underlying disparities in NIPT uptake, which undermines the goals of a national fetal aneuploidy screening program of providing reproductive autonomy and equitable access. This has ethical and policy implications for ensuring fair and responsible implementation of fetal aneuploidy screening.

Original languageEnglish
Pages (from-to)1395-1400
Number of pages6
JournalPrenatal Diagnosis
Volume41
Issue number11
Early online date9 Sep 2021
DOIs
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
This study was made possible using data from Peridos, the national digital registration system for prenatal screening in the Netherlands. The authors thank all Dutch NIPT Consortium members (see Supporting Information 1 ). The study is supported by a grant from the Netherlands Organization for Health Research and Development (ZonMw grant no. 543002001).

Publisher Copyright:
© 2021 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.

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