Factors Affecting Couples' Decision Making About Expanded Prenatal Cell-Free DNA Screening

Purpose

To assess intended parents' preferences about expanded prenatal cell-free DNA screening.

Methods

A survey was administered to couples who were pregnant or trying to conceive. Partners within couples were independently asked about willingness to seek prenatal cell-free DNA screening for diseases and traits that varied by severity, treatability, age of onset, and reliability. Additional questions explored couples' decision-making processes and how various factors would affect those decisions.

Results

Respondents (n = 494) were most likely to seek a prenatal genetic test when the test is completely predictive (P value of predictability effect = .0116), for earlier onset (P value of onset effect = .0310), treatable diseases (P value of treatability effect = .0032), and of highest severity (P value of severity effect < .0001). Living in states where termination was not available was not associated with decreased interest in prenatal screening, with 45% reporting that it would make them more likely to seek testing. There was moderate concordance between couples about their testing decisions and the majority of pregnant persons (68.8%) and partners (66.7%) desired firm screening recommendations from their doctors.

Conclusion

These data suggest that couples are highly information seeking when presented with all testing options neutrally, but most desire to be presented with firm testing recommendations from their clinician.