<p>Objective: Non-Invasive Prenatal Testing (NIPT) is increasingly being implemented worldwide. In public health programs, equitable access to healthcare is a fundamental principle which also applies to fetal aneuploidy screening. However, the out-of-pocket costs of NIPT may lead to sociodemographic disparities in uptake of screening. This study assessed whether there is a difference in the uptake of NIPT in socioeconomically disadvantaged neighborhoods compared to all other neighborhoods in the Netherlands, where NIPT is implemented in a national screening program (TRIDENT-2 study). Method: NIPT uptake, postal code and age of 156,562 pregnant women who received pre-test counselling for prenatal screening in 2018 were retrieved from the national prenatal screening database. Postal codes were used as a proxy to categorize neighborhoods as being either socioeconomically disadvantaged or other. The out-of-pocket costs for NIPT were €175. Results: NIPT uptake in socioeconomically disadvantaged neighborhoods was 20.3% whereas uptake in all other neighborhoods was 47.6% (p &lt; 0.001). The difference in NIPT uptake between socioeconomic disadvantaged neighborhoods and other areas was smaller for the youngest maternal age-group (≤25 years) compared to other age-groups. Conclusion: The variation in uptake suggest underlying disparities in NIPT uptake, which undermines the goals of a national fetal aneuploidy screening program of providing reproductive autonomy and equitable access. This has ethical and policy implications for ensuring fair and responsible implementation of fetal aneuploidy screening.</p>

doi.org/10.1002/pd.6043, hdl.handle.net/1765/136780
Prenatal Diagnosis
Erasmus MC: University Medical Center Rotterdam

Dutch NIPT Consortium, Karuna R.M. van der Meij, Caroline Kooij, Mireille N. Bekker, R.J.H. (Robert-Jan) Galjaard, & Lidewij Henneman. (2021). Non-invasive prenatal test uptake in socioeconomically disadvantaged neighborhoods. Prenatal Diagnosis, 41(11), 1395–1400. doi:10.1002/pd.6043