Non-invasive prenatal testing (NIPT) for fetal aneuploidy such as Down syndrome has rapidly transformed the global prenatal screening landscape. Until April 1, 2023, NIPT in the Netherlands was only available as part of two scientific studies: TRIDENT-1 and TRIDENT-2. The aim was to investigate all aspects for responsible implementation of NIPT in the Dutch prenatal screening program. Since April 2023 NIPT is part of the national prenatal screening programme carried out by the Center for Population Screening of the National Institute for Public Health and the Environment (RIVM-CvB).
TRIDENT-1 study (April 2014 – April 2023)
TRIDENT-1 included women who had an elevated risk of carrying a fetus with Down syndrome (or trisomy 18 or 13) based on first trimester combined test or medical history. A license was granted after positive advice by the Dutch Health Council.
TRIDENT-2 study (April 2017- April 2023)
After advice of the Dutch Health Council NIPT was offered as first-tier screening test to all ~170,000 pregnant women in The Netherlands. After counseling by a certified obstetric provider, women were given a choice between the combined test, NIPT or no prenatal screening. To create equal access, both tests were offered at comparable costs. The NIPT was subsidised by the Dutch government. Because most women who opted for prenatal screening chose NIPT, the combined test stopped in 2021.
The nationwide TRIDENT studies evaluated two parts of implementation:
- Part I. Organisation, logistics, outcome, test-performance and costs.
- Part II. Women’s decision-making, uptake, preferences, psychosocial aspects
Both TRIDENT studies ended April 2023. Since then, NIPT is part of the regular screening program and offered for free to all pregnant women. A list of publications can be found here.
The TRIDENT studies (TRIal by Dutch Laboratories for Evaluation of Non-invasive Testing) have been designed and were carried out by the Dutch NIPT Consortium. This Consortium is membered by all Dutch stakeholders involved in prenatal care including obstetricians, clinical geneticists, midwives, laboratory specialists, the VSOP Dutch Genetic Alliance, ethicists, and researchers. A list of all NIPT consortium members can be found here.
More information
- Prenatal screening programme in The Netherlands (by RIVM)
- English brochure about NIPT (from April 2023)
