Noninvasive Prenatal Diagnostic Tests, Ethics, Abortion, and Insurance Coverage.
Noninvasive, early fetal tests for sex, paternity, and chromosomal conditions will change pregnancy dramatically—and raise tricky ethical questions.
In 2003, back when such things remained unpredictable, a woman gave birth to a baby boy with Down syndrome. Her family was shocked. She had undergone the standard screening tests while pregnant—a blood test followed by an ultrasound—but the results had come back negative. Nor did she have the risk factors associated with Down, like advanced maternal age; she was 32. “She was not prepared for this,” recalls Matthew Rabinowitz, her brother. When the boy died six days later, his mother was devastated.
The event left a deep impression on Rabinowitz. A young Silicon Valley entrepreneur who had recently left Stanford with a Ph.D. in electrical engineering, he had just sold the second of two successful IT startups and was casting about for a new venture. Current methods of prenatal screening carry a significant margin of error, and his sister’s false negative suggested an opportunity. “I saw that we were applying our information technology and signal processing to various aspects of life, including cell phones and laptops, but not enough to the area of helping parents have healthy children,” says Rabinowitz.
A scientist in Hong Kong had recently shown that a pregnant woman’s blood contains a small amount of fetal DNA, and the prenatal screening world was buzzing about the potential of that discovery. Accurate blood tests, it was said, might soon reveal abundant information about the fetus as early as seven weeks of pregnancy. Rabinowitz drew on that excitement in 2004 when he founded Gene Security Network, later renamed Natera. Among the tests the company would develop was one to diagnose Down syndrome.