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. Aim was to investigate all aspects for responsible implementation of NIPT in the Dutch prenatal screening program. From April 2023 NIPT will be part of the national prenatal screening programme carried out by the RIVM.
TRIDENT-1 study (April 2014 – April 2023)
TRIDENT-1 includes women who are at an elevated risk of carrying a fetus with Down syndrome (or trisomy 18 or 13) based on first trimester combined test (FCT) or medical history. A license was granted after positive advice by the Dutch Health Council.
TRIDENT-2 study (April 2017- April 2023)
After the advice of the Dutch Health Council NIPT is offered as first-tier screening test to all ~170,000 pregnant women in The Netherlands. Women were given a choice between FCT, NIPT, or no prenatal screening. To create equal access, both tests were offered at comparable costs. The NIPT was subsidised by the Dutch government.
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. 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.