Women's choices for invasive or non-invasive testing: influence of gestational age and service delivery

Objective: To investigate the factors influencing women's post-counseling choices between non-invasive prenatal testing (NIPT) and invasive prenatal diagnosis in pregnancies with elevated a priori risk of fetal chromosomal abnormalities or after the initial screening.
Methods: Data were collected from test choice database at Fetomaternal Medical Center (FMC) at Helsinki University Hospital, Finland. We focused on the women with gestational age less than 15 weeks and who were offered NIPT or invasive procedure (CVS or amniocentesis) after pre-test counseling. The Chi-square test, ANOVA test and multinomial logistic regressions were used to explore significant factors affecting women's choice.
Results: In 2015, 333 women in our study group participated in prenatal testing, 260 (78.1%) initially chose NIPT, 62 (18.6%) chose CVS and 11 (3.3%) chose amniocentesis. There was a statistically significant difference among these three test groups with regard to gestational age (p = 0.025), counseling day (p < 0.001), certain medical indications and serum screening risk score (p = 0.028). However, multinomial logistic regressions only confirmed the predictive value of gestational age and counseling day on women's choice.
Conclusions: Maternal age was not a strong factor affecting women's choice for prenatal further tests. Medical indications and risk scores have less influence than previously thought. Gestational age and service availability were strong factors.