Emotions about testing negative with NIPT

A small percentage of women whose noninvasive prenatal testing (NIPT) results were negative regretted taking the test and blamed themselves, according to a 1-year postpartum questionnaire survey.

The authors of the Japanese study in the Journal of Human Genetics assigned this 6.7% of respondents to the negative emotion group. But 76.5% of the group noted they would like to take NIPT for their next pregnancy.

However, only 17.1% of the group reported they would recommend similar tests to their relatives and friends.

“This suggests that guilt over testing may be meaningful,” wrote the authors.

As of March 2019, only 2.1% of the 5,161 hospitals and clinics with ob/gyn departments in Japan performed NIPT.

The study comprised 526 NIPT-negative women who had received NIPT at Showa University Hospital in Tokyo and returned a questionnaire survey 1 year after the test. The survey was distributed between January 2018 and March 2019.

The anonymous, self-administered survey included questions about child outcomes and women’s impressions of NIPT and genetic counseling.

Responses were measured on a five-point Likert scale, ranging from “strongly agree” to “strongly disagree.”

Those who replied, “strongly agree/agree” to at least one of the questions were classified as the negative emotion group (n = 35), whereas those who replied, “disagree/strongly disagree” to at least one of the questions were classified as the control group (n = 484).

Three questions gauged a respondent’s mental state when receiving NIPT: Did you feel stressed when considering NIPT? Did you have any anxiety when considering NIPT? Did you feel depressed when considering NIPT?

The negative emotion group was significantly more likely to agree or strongly agree with these three questions than the control group (all Ps < 0.001).

“Our analysis revealed that women’s anxiety, stress, and depressive tendencies before the test tended to be stronger in the negative emotion group than in the control group,” wrote the authors.

The negative emotion group was also more likely to report that pre-test genetic counseling influenced their test selection than the control group (P < 0.005).

Although slightly over three quarters of the participants in the negative emotion group reported they desired to take NIPT for their next pregnancy, this percent was significantly lower compared to 92% of the control group.

Similarly, respondents in the control group noted they were nearly twice as likely to recommend similar tests to their relatives and friends than the negative emotion group: 31.9% vs. 17.1%.

Because abortion is criminalized in Japan and punitive views remain toward women who abort, the choice of undergoing prenatal testing is often construed to imply a future abortion.

No significant differences existed between the two groups regarding age, pregnancy duration, birth weight, reason for examination, pregnancy method, pregnancy history, miscarriage history, presence or absence of congenital disease, presence or absence of pregnancy complications, and working status.

The study validates the importance of addressing a pregnant woman’s psychosocial status during pre-test genetic counseling, according to the authors. And for those women who feel anxiety and stress, to listen to their reasons why.

“We believe it is possible to diminish anxiety by devising an environment in which pregnant women can easily express their anxieties during genetic counseling,” wrote the authors.

Source

Hirose T, Shirato N, Izumi M, et al. Postpartum questionnaire survey of women who tested negative in a non-invasive prenatal testing: examining negative emotions towards the test. J Hum Genet. Published online December 2, 2020. doi:10.1038/s10038-020-00879-6