35JDM INFORMED DECISION MAKING ON PRENATAL SCREENING AND EMOTIONAL WELL-BEING

Sunday, October 18, 2009
Grand Ballroom, Salons 1 & 2 (Renaissance Hollywood Hotel)
Danielle R.M. Timmermans, PhD1, Johanna H. Kleinveld, PhD2, Matthijs Van den Berg, PhD2, Leo Ten Kate, PhD, MD2 and John MG Van Vugt, PhD, MD2, (1)EMGO Institute/ VU University Medical Center, Amsterdam, Netherlands, (2)VU University Medical Center, Amsterdam, Netherlands

Purpose: Health care professionals and policy makers find it important that women are able to make an informed decision on prenatal screening. We collected data in the context of a large longitudinal study in which women were offered prenatal screening. Research questions were: Do women who made an informed decision compared to those who made an uninformed decision (1) differ in their emotional reaction when confronted with a positive screening test outcome? (2) feel less pressurized and more able to decide on prenatal diagnostic testing?

Method: In the large longitudinal study 44 midwifery and gynaecology practices in the Netherlands participated. Pregnant women attending these practices between May 2001 and May 2003 were asked to participate in the study. Women were offered the Nuchal Translucency Measurement (NTM) or the Maternal Serum Screening test (MST, also called triple test). Both give an estimation of the chance that the unborn child has Down Syndrome. Women received information about the prenatal screening test and had a consultation with their midwife or gynaecologist. Before the screening test was performed, informed decision making was measured by an extended Multidimensional Measure of Informed Choice (MMIC, Marteau et al., 2001)

Result: 1650 women were offered screening, of which 1421 returned the questionnaires. Of these women 625 (44%) had the test done and had returned the questionnaires, and 21 received a positive screening result. Seven women (35%) made an informed decision. Women who made an informed decision had a less adverse emotional reaction when confronted with the positive screening outcome compared to women who did not make an informed decision (M=3.7, SD=0.76 and M=4.4, SD=0.62 respectively, t(17)= 2.18, p=.043). They also felt more able to make a decision about whether or not to have a prenatal diagnostic test done (M=4.7, SD=0.49 and M=3.8, SD=0.87, respectively, t(16)=-2.46, p=.026). No significant difference was found between women who made an informed decision and those who did not, concerning feeling pressurized by others when deciding about prenatal diagnostic testing

Conclusion: In conclusion, compared to women who had not made an informed decision, those who had made an informed decision about prenatal screening had a less adverse emotional reaction when confronted with the positive screening outcome and felt more able to make a decision about prenatal diagnostic testing.

Candidate for the Lee B. Lusted Student Prize Competition