Knowledge of prenatal screening and psychological management of test decisions

Ultrasound Obstet Gynecol. 2011 Aug;38(2):152-7. doi: 10.1002/uog.8856.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Choice Behavior
  • Cross-Sectional Studies
  • Decision Making
  • Denmark / epidemiology
  • Down Syndrome / diagnosis*
  • Down Syndrome / epidemiology
  • Down Syndrome / psychology
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Informed Consent
  • Nuchal Translucency Measurement
  • Odds Ratio
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Pregnancy
  • Prenatal Diagnosis / methods*
  • Prenatal Diagnosis / psychology
  • Surveys and Questionnaires
  • Young Adult