Reassurance and Anxiety Reduction Meaningful Informed Decision Making Motivation for Non-Invasive Prenatal Testing Among Non-High Risk Patients: An Integrative Review of the Literature Eva Vanoer Faculty: Linda Graf, CNM, WHNP-C, DNP School of Nursing, DePaul University Background Conceptual Framework Results Low-risk mothers seek screening for reassurance and anxiety reduction, due to the accuracy of the testing, and to allow for meaningful decision making The effectiveness of NIPT in the low-risk population is uniform in performance to that of the high-risk population There are approximately four million births in the United States annually, of these live births, 1 in 33 is affected by birth defects Aneuploidy, or chromosomal anomalies, are among the most significant birth defects and account for an estimated 30-60% of all miscarriages The risk for trisomies increases with maternal age, previous children with trisomies, the presence of a balanced Robertsonian translocation in at least one parent, maternal obesity, use of tobacco products, and radiation exposure Non-invasive prenatal testing (NIPT) has allowed for highly accurate screening for trisomy 21, 18, and 13 in high-risk expectant mothers since 2011 Despite high costs, ranging from $1700-$295, it is now often being used in the low-risk population Few studies exist that illustrate why low-risk mothers want to elect this screening and if it as effective for them as it is for the high-risk population Orem’s self-care theory was the conceptual framework used for this study Centers on individuals initiating activities independently to maintain personal health and well-being Engage in continuous communication with self & environments in order to function Seeking knowledge of potential health problems is necessary for promoting self-care The concepts within Orem’s theory suggest that expectant mothers elect NIPT in order to maintain self-care and wellbeing The information received from the screening, whether positive or negative, allows for self-care to occur and for attainment of developmental self-care requisites Motivator Key Insights Reassurance and Anxiety Reduction To confirm risk status To reassure the wellbeing of the fetus To reduce maternal anxiety levels Accuracy of Testing More accurate over traditional screening modalities, such as biochemical assays and ultrasonography lower rates of false-negative and false-positive test results To obtaining most accurate info about fetus Higher accuracy reduced need for more invasive procedures Meaningful Informed Decision Making Ability to make meaningful decisions about the pregnancy based on the results Ability to prepare in the event of a positive result Guiding termination decisions Ability to know earlier in the pregnancy prior to strong emotional bonding More in favor due to low fear of miscarriage from the procedure Self-Care Self-care demands Nursing Agency Self-Care Agency Limitations Very limited number of research articles are available on the low-risk expectant mother population and what motivates them to accept NIPT Further studies using this specific population would be beneficial in understanding truly why they opt to obtain this expensive screening over existing screening methods Additional studies on low-risk minority mothers would also provide more in depth understanding of the low-risk population and their concerns about aneuploidy in the prenatal period Deficit Purpose Identify key motivators that influence low risk expectant mothers to undergo NIPT Evaluate the effectiveness of NIPT for low-risk patients Conclusion Method It was evident that low-risk expectant mothers accept NIPT for anxiety reduction and reassurance More mothers are opting for this testing over the previous screening methods because of the high accuracy and specificity of the screening NIPT allows early access to genetic information, thus providing families the opportunity to make thoughtful decisions in regards to their pregnancies NIPT is just as effective in low-risk populations, and it is has improved accuracy over traditional screening methods Due to the high interest in NIPT, nurses should expect genetic counseling to become a much larger aspect of prenatal care in the future This study utilized an integrative literature review to locate relevant literature from the last ten years to determine motivators for low-risk mothers to undergo NIPT and its effectiveness. The databases CINHAL, ProQuest, PsychInfo, and PubMed were used for the search Inclusion criteria consisted of articles available in English, written within the last ten years, all publication types, and content related to the relevant key words Key Words: non-invasive prenatal testing, non-invasive prenatal screening, cell-free DNA testing, NIPT, motivation Research Questions Why do low risk mothers elect to undergo NIPT testing instead of, or in addition to current standard screening methods? Is NIPT as effective at diagnosing trisomies for low-risk patients as it is for high risk patients?