Pregnant Women's Attitudes to and Knowledge of Non-invasive Prenatal Testing in Down Syndrome Screening in Hong Kong

Objectives: To evaluate pregnant women’s attitudes to and knowledge of non-invasive prenatal testing in Down syndrome screening. Methods: From 1 November 2012 to 31 December 2012, all pregnant Chinese women who attended for Down syndrome screening were invited to complete a self-administered questionnaire, which enquired about their knowledge and attitudes regarding non-invasive prenatal testing. Those who subsequently screened positive for Down syndrome were given the same questionnaire again. Results: A total of 651 pregnant women were included, of whom 439 (67.4%) returned their questionnaires after Down syndrome screening (group 1). Among 29 patients who screened positive for Down syndrome, 16 (55.2%) completed the questionnaire for the second time (group 2). Most of the women in group 1 were aware of firsttrimester combined Down syndrome screening (78.1%), second-trimester biochemical screening (66.7%), and invasive tests (78.4%). However, only 96 (21.9%) were aware of non-invasive prenatal testing. The mean overall knowledge score on non-invasive prenatal testing in group 1 patients was 2.55 of 9, with a significantly higher score in women who were of higher education level, higher family income, undergoing antenatal care in both the public and private sectors, and those with positive Down syndrome screening (group 2). Overall, 328 (74.7%) would consider having non-invasive prenatal testing. However, about one-third would still proceed to diagnostic tests even when non-invasive prenatal testing was negative. Over 80% would like the public sector to provide non-invasive prenatal testing, of whom 52.8% considered that this should be free of charge. Conclusion: Non-invasive prenatal testing is relatively new. It is not surprising that this study showed an overall low level of knowledge. Although most pregnant women preferred the test to be provided free of charge by the public sector, adequate counselling and information should still be provided.