ONTARIO MATERNAL SERUM SCREENING-PROGRAM - PRACTICES, KNOWLEDGE AND OPINIONS OF HEALTH-CARE PROVIDERS

Objective: To determine the practices, knowledge and opinions of healt h care providers regarding a prenatal genetic screening program in Ont ario. Design: Cross-sectional self-reported survey. Setting: Ontario. Participants: Random sample of 2000 family physicians, all 565 obstetr icians and all 62 registered midwives in the province. Among subjects who were eligible (those providing antenatal care or attending births) the response rates were 91% (778/851), 76% (273/359) and 78% (46/59) respectively. Main outcome measures: Which patients were offered mater nal serum screening. (MSS), how results were being communicated, knowl edge of the test's sensitivity, likes and dislikes about MSS and recom mendations regarding the program. Results: Most (97%) of respondents s tated that they were offering MSS to the pregnant women in their pract ices; 88% were offering it routinely to all pregnant women (87% of the family physicians, 90% of the obstetricians and 100% of the midwives) . Most (92%) of the respondents stated that they communicate positive results to their patients personally as soon as they are received; 23% did so for negative results. The respondents correctly identified the initial positive rate but underestimated the false-positive rate. Abo ut one-third did not respond to these knowledge questions. Of those wh o gave feedback on the screening program, 50% recommended that it not be changed, 29% suggested that it be changed, and 22% recommended that it be scrapped. Conclusions: Participation in the Ontario Maternal Se rum Screening Program by health care providers has been good, although knowledge about MSS is far from ideal. Many providers have reservatio ns about the program. In light of concerns raised about the high false -positive rate and the anxiety such results generate in pregnant women , there is a need for more education of providers and patients and a b etter understanding of women's experiences with genetic screening.