■孕妇可以在整个生育过程中从不同的产前基因检测中进行选择。我们的目标是研究临床,社会,和影响不同选择的经济决定因素(非侵入性,侵入性,或两者)。
■托斯卡纳地区发起了一项针对生育途径的系统调查,意大利,收集孕妇经历的数据,结果和满意度。根据这项调查,我们回顾性分析了2019年3月至2023年2月填写孕中期问卷的女性数据(n=27,337),提供有关相关变量的完整数据。应用Logistic回归模型来确定导致选择非侵入性产前检测(NIPT)和侵入性检测的可能性较高的因素。
■在参与者中,42.7%只选择了NIPT,3.8%的人只选择了侵入性测试,1.3%的人接受了两项测试,52.2%的人没有进行基因检测。NIPT更常被老年人选择,意大利语,受过高等教育,未产妇女,认为健康更好的人,受雇(与失业相比),有较高的经济地位,计划怀孕,接受医院护理(与咨询中心相比),在妇科医生的监督下(与助产士相比),没有选择联合检测和接受妊娠疫苗接种。相反,侵入性检测在老年妇女中更普遍,但在未分娩的妇女中不太常见,有意大利国籍,并且有更好的健康状况。这一组也倾向于经历计划外和高风险的怀孕,怀孕期间没有服用叶酸,获得公立医院援助,不太经常选择组合测试或NIPT,考试经常延误。
■超出临床考虑的各种因素影响产前检查的选择。因此,NIPT途径应包括平衡,关于益处和局限性的高质量信息,确保实验室专家积极参与决策。
UNASSIGNED: Pregnant women can choose from different prenatal genetic tests throughout their maternity journey. We aim to investigate the clinical, societal, and economic determinants influencing the selection of different options (non-invasive, invasive, or both).
UNASSIGNED: A systematic survey focusing on maternity pathways was launched by the Region of Tuscany, Italy, to collect data on pregnant women\'s experience, outcomes and satisfaction levels. Drawing from this survey, we retrospectively analyzed data on women who filled out the second-trimester questionnaire between March 2019 and February 2023 (n = 27,337), providing complete data on relevant variables. Logistic regression models were applied to identify the factors contributing to a higher likelihood of opting for non-invasive prenatal testing (NIPT) and invasive testing.
UNASSIGNED: Among the participants, 42.7 % chose only NIPT, 3.8 % opted for invasive tests exclusively, 1.3 % underwent both tests, and 52.2 % did not pursue any genetic testing. NIPT was more often chosen by older, Italian, highly educated, nulliparous women, who perceived better health, were employed (versus unemployed), had higher economic status, planned pregnancy, received hospital-based care (versus counseling center), under gynecologist supervision (versus midwife), not opted for combined testing and received pregnancy vaccinations. Conversely, invasive testing was more prevalent among older women but less common among those who were nulliparous, had Italian nationality, and had a perceived better health status. This group also tended to experience unplanned and high-risk pregnancy, did not take folate during pregnancy, received public hospital-based assistance, less frequently chose combined tests or NIPT, and had frequent delays in examinations.
UNASSIGNED: Various factors beyond clinical considerations influence the selection of a prenatal test. Therefore, NIPT pathways should include balanced, high-quality information about benefits and limitations, ensuring laboratory specialists\' active and integrated involvement in decision-making.