Obstet Gynecol Sci.  2018 Jul;61(4):453-460. 10.5468/ogs.2018.61.4.453.

Change in rates of prenatal tests for chromosomal abnormality over a 12-year period in women of advanced maternal age

Affiliations
  • 1Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea. obdrmhk@naver.com
  • 2Institute of Health and Environment, Seoul National University, Seoul, Korea.

Abstract


OBJECTIVE
In 2007, the American College of Obstetricians and Gynecologists (ACOG) recommended that all pregnant women be offered screening or diagnostic tests for chromosomal abnormalities regardless of their age. Noninvasive prenatal testing (NIPT) for common chromosomal aneuploidies was introduced as a screening test in case of high-risk pregnancies. 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), serum screening, and NIPT from January 2005 through March 2017 in women aged 35 years and older. We divided the initial 12 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 NIPT introduction, 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 NIPT were 19.9%, 30.3%, and 39.5% (P=0.007), respectively. The rates of CVS over the same periods were not significantly different.
CONCLUSION
The ACOG statement and NIPT introduction significantly decreased the rate of amniocentesis in women of advanced maternal age. NIPT also reduced the rate of serum screening.

Keyword

Noninvasive prenatal testing; Prenatal diagnosis; Maternal age

MeSH Terms

Amniocentesis
Aneuploidy
Chorionic Villi Sampling
Chromosome Aberrations*
Diagnostic Tests, Routine
Female
Humans
Mass Screening
Maternal Age*
Pregnancy
Pregnancy, High-Risk
Pregnant Women
Prenatal Diagnosis
Retrospective Studies
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