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A blood test that can predict if a fetus will have Down syndrome is growing in popularity. But because it can lead some couples to end pregnancies, it is sparking a debate.

Disability rights’ advocates, researchers and clinicians note that people are now living longer, healthier and more productive lives with Down syndrome, a genetic condition that causes intellectual disability, developmental delays and certain medical problems.

Advocates worry that wider use of the test, which is more accurate than older noninvasive screenings, will lead more couples to end pregnancies without understanding how life with Down syndrome has dramatically changed for many people. Some researchers and doctors also are concerned that not enough is known yet about the rate of false positives, and that women may not be properly counseled on how to interpret the results.

“The test is a great test, but it needs to be understood before it can be used effectively,” said Mary Norton, a professor of obstetrics, gynecology and reproductive sciences and the University of California, San Francisco, and president of the Perinatal Quality Foundation, which is...