Noninvasive Prenatal Testing in the Developing World: Ethical, Legal, Social and Practical Challenges (2013-2014)

Noninvasive prenatal testing (NIPT) can accurately detect fetal chromosomal aneuploidies (e.g., Down syndrome or trisomy 21) by analyzing cell-free fetal DNA in the pregnant mother’s blood. It could potentially change management of pregnancy and prenatal care by reducing the need for invasive procedures like amniocentesis and chorionic villus sampling that risk loss of pregnancy.

To address these and many other complex questions, this project team gathered background and state-of-the-art information about NIPT in developing countries. These data informed the development of in-depth case studies for two countries. Team members identified the main issues that stakeholders, nongovernmental organizations and international organizations including the World Health Organization should consider for appropriate implementation of NIPT in low- and middle-income countries as these technologies rapidly enter the global marketplace.



Team Outcomes

Global Spread of NIPT (project website)

Commercial Availability of Non-Invasive Prenatal Testing in Low- and Middle-Income Countries: Ethical and Policy Implications (poster by Megan Allyse, Elisa Berson, Anthony Hung, Dechen Lama, Grace Li, Margaret Rote, Shilpa Shridar, Mollie A. Minear, and Subhashini Chandrasekharan)

Difference in Attitudes on Noninvasive Prenatal Testing in China and the United States (poster by Grace Li and Megan Allyse)

Minear, MA, Lewis, C, Pradhan, S, and Chandrasekharan, S. “Global perspectives on clinical adoption of NIPT.” Prenatal diagnosis 35, no. 10 (October 2015): 959-967. Full Text

CORRIGENDUM: Too much, too soon?: Commercial provision of noninvasive prenatal screening for subchromosomal abnormalities and beyond.” Genetics in Medicine 17, no. 6 (June 2015): 515-515. Full Text

Allyse, M, Minear, MA, Berson, E, Sridhar, S, Rote, M, Hung, A, and Chandrasekharan, S. “Non-invasive prenatal testing: a review of international implementation and challenges.” International journal of women's health 7 (January 16, 2015): 113-126. (Review) Full Text

Haidar, H, Rispler-Chaim, V, Hung, A, Chandrasekharan, S, and Ravitsky, V. “Noninvasive Prenatal Testing: Implications for Muslim Communities.” AJOB Empirical Bioethics 6, no. 1 (January 2, 2015): 94-105. Full Text

Minear, MA, Alessi, S, Allyse, M, Michie, M, and Chandrasekharan, S. “Noninvasive Prenatal Genetic Testing: Current and Emerging Ethical, Legal, and Social Issues.Annual review of genomics and human genetics 16 (January 2015): 369-398. Full Text

Chandrasekharan, S, Minear, MA, Hung, A, and Allyse, M. “Noninvasive prenatal testing goes global.” Science translational medicine 6, no. 231 (April 2014): 231fs15-. Full Text

This Team in the News

Connecting the Dots

New Prenatal Tests Pose Challenges for Developing World

Abortion Laws and Genome Science

Expanding My Knowledge and Skillset

The Wholly Unexpected But Absolutely Necessary


Team Leaders

  • Subhashini Chandrasekharan, Duke Global Health Institute
  • Robert Cook-Deegan, Sanford School of Public Policy
  • Amy Murtha, School of Medicine-Obstetrics and Gynecology

/graduate Team Members

  • Jenae Logan, Global Health - MSc

/undergraduate Team Members

  • Elisa Berson, Biology (BS)
  • Anthony Hung, Biology (BS)
  • Dechen Lama, Public Policy Studies (AB), Global Health (AB2)
  • Grace Li, Biology (BS)

/yfaculty/staff Team Members

  • Megan Allyse, Science & Society
  • Mollie Minear, Sanford School of Public Policy
  • Subarna Pradhan, Duke Global Health Institute

/zcommunity Team Members

  • Vardit Ravitsky, University of Montreal