Chromosomal microarray use among women undergoing invasive prenatal diagnosis

Prenat Diagn. 2016 Jul;36(7):656-61. doi: 10.1002/pd.4835. Epub 2016 Jun 9.

Abstract

Objective: To study the offer and uptake of chromosomal microarray analysis (CMA) among women undergoing invasive prenatal testing.

Methods: This is a retrospective cohort study of women who underwent chorionic villus sampling (CVS) or amniocentesis. Charts were reviewed for CMA offer and uptake, in additional to clinical and demographic variables.

Results: One hundred forty-one women underwent CVS (n = 53) or amniocentesis (n = 91) over the study period. Overall, 41% of women underwent CMA. Women who underwent invasive testing for a fetal structural abnormality were more likely to undergo CMA than women who underwent invasive testing for all other indications (aOR 43.18, 95% CI 4.64 - 401.58). Chromosomal microarray was offered more often to women who primarily spoke English (p < 0.001), self-identified as white (p = 0.046) and did not receive prenatal care in a community health center (p = 0.044). Statistically significant differences in CMA uptake by race/ethnicity, language, insurance or provider type were not noted. Multiparous women were less likely to accept this test than nulliparas (aOR 0.39, 95% CI 0.17 - 0.86).

Conclusion: Women who undergo invasive fetal testing are more likely to undergo CMA if the indication is for a fetal structural anomaly. There may be important demographic disparities in the offering of CMA which bear further exploration. © 2016 John Wiley & Sons, Ltd.

MeSH terms

  • Adult
  • Amniocentesis*
  • Chorionic Villi Sampling*
  • Chromosome Disorders / diagnosis*
  • Cohort Studies
  • Community Health Centers
  • Ethnicity
  • Female
  • Humans
  • Language
  • Logistic Models
  • Maternal Age
  • Microarray Analysis / statistics & numerical data*
  • Multivariate Analysis
  • Practice Patterns, Physicians'
  • Pregnancy
  • Prenatal Diagnosis
  • Retrospective Studies
  • White People