As of: 08/19/2021 6:58 p.m.
With a blood test during pregnancy, parents-to-be can determine whether their child has a trisomy. So far, the NIPT test had to be paid privately – from 2022 it will be a health insurance benefit.
Blood tests for pregnant women for Down syndrome and other trisomies in children will in future be paid for by health insurance companies. The Federal Joint Committee of Doctors, Clinics and Health Insurance Funds approved patient information as the last step in Berlin. The women should be as well informed as possible with their doctor and decide whether they want to carry out a test. First of all, the Federal Ministry of Health now has two months to carry out a further examination before it can be published in the Federal Gazette.
Only “in justified individual cases”
The blood test is expected to be offered as a health insurance service from spring 2022. As early as 2019, the federal committee and the ministry had given the go-ahead for the test in principle. It should only be carried out “in justified individual cases in pregnancies with special risks,” it said. An intensive medical consultation is a prerequisite for the assumption of costs.
In the non-invasive prenatal tests that have been offered in Germany since 2012, genetic components of the child are isolated from the pregnant woman’s blood from the tenth week of pregnancy and examined for genetic defects such as trisomy 21.
In Down syndrome, people have one more chromosome in each cell than others. Chromosome 21 is present three times, hence the name trisomy 21. The consequences are physical abnormalities and slowed motor, mental and linguistic development. However, characteristics are very different. In addition to Down syndrome, the test can also detect the rarer and more severe trisomies 13 and 18.
Critics warn of increasing discrimination
Proponents describe the tests as reliable and safe: In healthy children of pregnant women, they achieve a true negative test result for the risk of trisomy 21 in 99.91 percent of the cases – regardless of age. The sensitivity for true positive results is 99.2 percent. Until the procedure was approved in 2012, only invasive tests were possible, such as the removal of amniotic fluid. However, this increases the risk of miscarriages.
Critics such as associations for the disabled and the Catholic Church warn that an expansion of the tests would lead to increasing discrimination against people with disabilities and, in most cases, to the termination of such pregnancies.
“Will not meet with unanimous approval”
“The Federal Joint Committee never made it easy for itself,” said chairman Josef Hecken. “We are aware that the decision will not meet with unanimous approval in all social groups.” It is a reality, however, that “this blood test cannot cause any miscarriages compared to the invasive examinations,” added Hecken. “It is both rationally and medically correct to offer a safe alternative to those pregnant women for whom knowledge of a trisomy is personally important.”
Parents who want to take the test should not only receive medical advice but also be given a brochure in which the parents-to-be are asked to find out beforehand what they want to do if the test result is abnormal. It is also emphasized that it is not one of the generally recommended preventive examinations.
Blood tests for pregnant women are covered by health insurance
Mia von Hirsch, ARD Berlin, August 19, 2021 8:02 p.m.