{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T21:05:30Z","timestamp":1775509530664,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T00:00:00Z","timestamp":1600041600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the effectiveness of secondary screening using non\u2010invasive prenatal testing (NIPT) in a routine NHS setting including test performance, turn\u2010around times (TATs) and no\u2010call (failure to obtain result) rates. To examine the influence of maternal and fetal characteristics on test performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>London teaching hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A total of 8651 pregnancies undergoing screening for fetal trisomy using NIPT provided by an NHS cell\u2010free DNA screening laboratory\u00a0\u2013\u00a0the SAFE laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Screening test evaluation and TATs. Univariate and multivariate logistic regression analysis to identify significant predictors of no\u2010call results and reported by low fetal fraction (&lt;2%), very high fetal fraction (&gt;40%) and processing failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Test performance, TATs and no\u2010call rates, factors affecting no\u2010call results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Average TAT was 4.0\u00a0days (95% CI 4.0\u20134.2\u00a0days). Test sensitivities for trisomies 21 and 13\/18 were 98.9% (95% CI 95.9\u201399.9%) and 90.4% (95% CI 80.0\u201396.8%), respectively. The overall no\u2010call rate was 32\/8651 (0.37%, 95% CI 0.26\u20130.52%). The overall risk of a no\u2010call result was influenced by gestational age, dichorionic twin pregnancy, history of malignancy and pregnancies affected by trisomy 13\/18, but not by maternal weight or use of low\u2010molecular\u2010weight heparin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010throughput NIPT can be effectively embedded into a public health NHS setting. TATs of 4\u00a0days and no\u2010calls of &lt;0.5% were well within clinically desirable tolerances. Gestational age, maternal weight, assisted reproductive techniques, use of low\u2010molecular\u2010weight heparin and past history of malignancy did not have major impacts on test no\u2010call rates and should not constitute reasons for withholding the option of NIPT from women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Turn\u2010around times of 4\u00a0days, no\u2010call (test failure) rates of 0.37% and highly accurate NIPT can be successfully embedded in the NHS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16464","type":"journal-article","created":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T13:53:44Z","timestamp":1597326824000},"page":"440-446","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Secondary non\u2010invasive prenatal screening for fetal trisomy: an effectiveness study in a public health setting"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8198-9698","authenticated-orcid":false,"given":"GP","family":"Guy","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust London UK"},{"name":"Vascular Biology Research Centre Molecular and Clinical Sciences Research Institute St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Hargrave","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust London UK"},{"name":"St George's Antenatal Fetal Evaluation (SAFE) Laboratory St George's Hospital St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Dunn","sequence":"additional","affiliation":[{"name":"St George's Antenatal Fetal Evaluation (SAFE) Laboratory St George's Hospital St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Price","sequence":"additional","affiliation":[{"name":"St George's Antenatal Fetal Evaluation (SAFE) Laboratory St George's Hospital St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Short","sequence":"additional","affiliation":[{"name":"St George's Antenatal Fetal Evaluation (SAFE) Laboratory St George's Hospital St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust London UK"},{"name":"Vascular Biology Research Centre Molecular and Clinical Sciences Research Institute St George's University of London London UK"},{"name":"St George's Antenatal Fetal Evaluation (SAFE) Laboratory St George's Hospital St George's University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the SAFE test collaborative","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,14]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"UK National Screening Committee: NHS Fetal Anomaly Screening Programme Handbook2018 Published August 2018 PHE Publications [https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachatta_data\/file\/749742\/NHS_fetal_anomaly_screening_programme_handbook_FINAF1.2_18.10.18.pdf]. 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