Abstract

Objective: This study aimed to assess the influence of cultural and religious beliefs on decision-making, identify sources of information, and determine barriers affecting the uptake of non-invasive prenatal testing (NIPT).
Methods: A cross-sectional survey was conducted among 435 women in Saudi Arabia using a structured questionnaire assessing sociodemographic characteristics, beliefs, barriers, information sources, and confidence in decision-making. Descriptive statistics, chi-square tests, and multivariable logistic regression were applied to evaluate factors associated with moderate-high confidence.
Results: Most participants were aged 18-35 years (n = 322, 74.0%) and held a bachelor’s degree (n = 290, 66.7%). Willingness to undergo testing was reported by 289 (66.4%), and 307 (70.6%) would recommend it to others. Information-seeking was high, with 379 (87.1%) desiring detailed fetal health information. Religious considerations were notable, with 291 (66.9%) considering testing permissible and 288 (66.2%) seeking religious guidance. The main barriers included anxiety about positive results (n = 304, 69.9%), miscarriage concerns (n = 238, 54.7%), high cost (n = 193, 44.4%), and inadequate counseling (n = 197, 45.3%). Most women reported moderate confidence (n = 230, 52.9%), while 154 (35.4%) were completely confident. Higher income (aOR 1.93, 95% CI 1.33-2.81) and area of residence (aOR 1.39, 95% CI 1.01-1.92) independently predicted greater confidence. Healthcare professionals were the primary information source (31.6%).
Conclusion: Cultural and religious beliefs shaped decision-making without limiting acceptance of NIPT. Psychological, financial, and informational barriers reduced confidence. Strengthening counseling, improving affordability, and expanding access might enhance informed and equitable utilization of NIPT.

Key words: Women, decision-making, non-invasive prenatal testing, Saudi Arabia, religious beliefs, sources of information