Factors affecting couples’ decision making about expanded prenatal cell-free DNA screening

Abstract

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.

Keywords

• Bioethics
• cfDNA
• Prenatal testing