Knowledge of prenatal screening and psychological management of test decisions

• Published in: Ultrasound in obstetrics & gynecology Vol. 38; no. 2; pp. 152 - 157
• Main Authors: Dahl, K., Hvidman, L., Jørgensen, F. S., Kesmodel, U. S.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-08-2011; Wiley; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Biological and medical sciences; Choice Behavior; Chromosome aberrations; Cross-Sectional Studies; Decision Making; decisional conflict; Denmark - epidemiology; Down syndrome; Down Syndrome - diagnosis; Down Syndrome - epidemiology; Down Syndrome - psychology; Down's syndrome; Female; Gynecology; Gynecology. Andrology. Obstetrics; Health Knowledge, Attitudes, Practice; Humans; Informed Consent; Medical genetics; Medical sciences; Nuchal Translucency Measurement; nuchal translucency screening; Obstetrics; Odds Ratio; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Pregnancy; Prenatal diagnosis; Prenatal Diagnosis - methods; Prenatal Diagnosis - psychology; prenatal screening; psychological wellbeing; Regression analysis; Surveys and Questionnaires; Ultrasound; worry; Young Adult; Denmark; Chromosomal aberration; worry; Trisomy; Gynecology; Psychology; decisional conflict; Chromosome G21; Aneuploidy; Well being; Psychometrics; nuchal translucency screening; Down syndrome; Medical screening; Knowledge; Obstetrics; Decision; Quality of life; psychological wellbeing; Clinical management; Prenatal diagnosis; Treatment; Nuchal translucency; Informed consent; prenatal screening
• ISSN: 0960-7692; 1469-0705; 1469-0705
• DOI: 10.1002/uog.8856

Objectives
To study associations between pregnant women's knowledge of prenatal screening and decisional conflict in deciding whether to participate in first‐trimester screening for Down syndrome in a setting of required informed consent, and to study associations between knowledge and personal wellbeing, and worries in pregnancy.
Methods
A population‐based cross‐sectional study with 6427 pregnant women consecutively included before the time of a nuchal translucency scan. Participants were recruited from three Danish obstetric departments offering prenatal screening free of charge. The results presented are based on 4111 pregnant women (64%). Knowledge was measured using 15 questions. The primary outcomes were measured using pre‐existing validated scales, i.e. The Decisional Conflict Scale, the WHO Well‐Being Index and the Cambridge Worry Scale. Associations were analyzed by multivariate logistic and linear regression analyses.
Results
A higher level of knowledge was associated with less decisional conflict when deciding whether to participate in first‐trimester Down syndrome screening (adjusted odds ratio 1.31 (95% CI, 1.26–1.37)). An increased level of knowledge was also associated with higher levels of wellbeing (adjusted linear coefficient 0.51 (95% CI, 0.26–0.75), P < 0.001). Knowledge was not associated with worries, either in general or specifically about something being wrong with the baby.
Conclusion
The results of this study indicate the importance of ensuring a high level of knowledge for pregnant women making choices about participation in prenatal screening for Down syndrome in order to improve the psychological management of test decisions. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.