Are pregnant Australian women well informed about prenatal genetic screening? A systematic investigation using the Multidimensional Measure of Informed Choice.

Full Abstract

BACKGROUND:
Ethical practice requires that decisions to participate in medical care be well informed. Investigations into prenatal genetic screening for Down syndrome have assessed women's knowledge but have not examined whether being well informed about the potential consequences of screening, such as subsequent diagnostic testing, diagnosis and termination, is associated with psychological distress for women.

AIMS:
To assess informed choice to participate in second trimester maternal serum screening (2MSS) in pregnant women using a validated measure and to compare anxiety levels in women who were well informed versus poorly informed.

METHODS:
A prospective cohort study where pregnant women completed the Multidimensional Measure of Informed Choice and the Hospital Anxiety and Depression Scale immediately prior to the offer of 2MSS. Follow-up questionnaires assessing psychological symptomatology were completed at 20 and 30 weeks gestation.

RESULTS:
Only 37% of decisions were informed; those who participated in screening were more likely to have made an informed decision than those who did not (P = 0.01); 31% did not know that miscarriage was a possible consequence of diagnostic testing subsequent to an increased risk screening result and only 62% correctly identified that termination of pregnancy would be offered if Down syndrome were to be diagnosed. Short-term anxiety levels in those who were well informed were not significantly different from those who were poorly informed (P = 0.14).

CONCLUSIONS:
Health promotion strategies, which are readily applicable in clinical settings and address diverse learning needs and attitudes of pregnant women, are needed. The impact of antenatal screening on other dimensions of pregnancy psychology remains to be investigated.

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Author information

Author/s: Rowe, Heather J (HJ); Fisher, Jane R W (JR); Quinlivan, Julie A (JA);

Affiliation: Key Centre for Women's Health in Society, School of Population Health, University of Melbourne, Melbourne, Victoria, Australia. h.rowe(-atsign-)unimelb.edu.au

Journal and publication information

Publication Type: Journal Article

Journal: The Australian & New Zealand journal of obstetrics & gynaecology (Aust N Z J Obstet Gynaecol), published in Australia. (Language: eng)

Reference: 2006-Oct; vol 46 (issue 5) : pp 433-9

Dates: Created 2006/09/06; Completed 2007/01/09;

PMID: 16953859, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Aust N Z J Obstet Gynaecol. 2006 Oct;46(5):370-1. (PMID: 16953847)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Anxiety - diagnosis
Australia
Choice Behavior
Cohort Studies
Down Syndrome - blood; diagnosis
Female
Genetic Screening - psychology

Health Knowledge, Attitudes, Practice
Humans
Patient Acceptance of Health Care
Pregnancy
Pregnancy Trimester, Second
Prospective Studies
Questionnaires

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