NIPT: give parents the full story

Dear Editor,

I was delighted to read the article (Lancaster, 2019) in British Journal of Midwifery (BJM), discussing the importance of continuing the conversation around prenatal screening and, in particular, non-invasive prenatal testing (NIPT).

One of the many issues with NIPT is that some of the ways it has been described during commercial marketing are misleading to consumers and professionals. The concern is that women may then make decisions informed by the ‘popular’ view of what NIPT is, rather than the factual. Some of these misleading statements are quite subtle but important.

The DNA analysed is a mixture of the mother's DNA and the DNA from the placenta. This is not DNA from the fetus and is one of the reasons that the test may be wrong, due to placental mosaicism. Describing the DNA as ‘fetal’ or ‘from the fetus’ is at best misleading and at worst incorrect, as barely any DNA passes from the fetus through the placenta—certainly not enough to give results for NIPT. It also gives the impression that it is the baby's DNA being directly analysed, which may, in women's minds, imply greater accuracy than is possible with NIPT.