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Discuss ways to ease pregnant women’s concerns about NIPT tests

The Yomiuri ShimbunThe day has come when maladies in unborn babies can be discovered through blood tests. It is essential to fundamentally debate how we deal with reproductive medicine, which is rapidly advancing.

As early as this autumn, the Health, Labor and Welfare Ministry is set to establish a study panel regarding noninvasive prenatal testing (NIPT), a method for examining whether unborn babies have chromosome-related medical conditions. The group is expected to discuss such matters as the appropriateness of expanding NIPT checkups and how pertinent information should be provided to pregnant women.

NIPT tests collect blood from pregnant women that is used to discover three diseases, including Down syndrome. Based on the guidelines set by the Japan Society of Obstetrics and Gynecology (JSOG), such testing is conducted at 92 designated hospitals with full-time pediatricians and obstetrician-gynecologists with expertise in genetic medical treatment.

As a general rule, the test-takers are pregnant women aged 35 or older. There is a higher risk of Down syndrome among children born to older mothers. The increase in women who undergo NIPT tests reflects the influence of the tendency to marry late.

It should be noted that pregnant women have to make serious decisions when their unborn babies are found to have certain conditions. Accepting their babies’ disorders, some parents have their children and raise them with care. Since the start of NIPT testing in 2013, however, more than 90 percent of people at designated hospitals have opted for abortions after their unborn babies were found to have certain conditions.

For pregnant women to make a decision they can accept, it is indispensable to ensure they properly understand their children’s condition and receive careful explanations. The problem is there has been a sharp increase in recent years in people who take NIPT tests at undesignated facilities whose consultation systems are not necessarily adequate.

Improve counseling services

As a measure to deal with the problem, JSOG has announced a plan to relax the related requirements, with a view to enabling any hospital to carry out NIPT tests if it has one obstetrics and gynecology specialist who has undergone practical training. The Japan Pediatric Society (JPS) and the Japan Society of Human Genetics (JSHG) have opposed this move by the JSOG, saying NIPT testing should not be conducted under inadequate systems and without much consideration.

The health ministry’s latest measure to start a study of NIPT-related issues seems to indicate that it senses a limit to what can be achieved by leaving medical associations to decide how to deal with the problem. In the past, related medical societies have decided how medical tests should be conducted. If they remain divided over the issue, however, it could spread anxiety among pregnant women.

The focus of attention in the future will be how requirements should be set for facilities to be designated as capable of appropriate tests, while also making these requirements fully known to medical institutions.

To dispel the concerns of pregnant women, it is important to make such efforts as providing them with information about post-delivery support systems and paying careful attention to the mental conflicts of such women and their husbands. As circumstances stand now, there is a shortage of expert counselors. Efforts must be made to improve the quality of training for such personnel engaged in actual medical practice.

It is also necessary to improve welfare systems and promote understanding among the public in this respect, so children born with disabilities do not struggle to live their lives.

There is no doubt that, due to advancements in reproductive medicine, more maladies will be discovered in unborn babies. It is hoped that there will be an exploration of even such issues as the extent to which unborn children’s conditions should be identified.

(From The Yomiuri Shimbun, July 3, 2019)Speech



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