WOMENS EXPERIENCES OF PRENATAL SERUM SCREENING

Background: Maternal serum screening is used to detect pregnancies at risk for Down syndrome and neural tube defects, but most positive test results (6.6% of all) are false positives. This study examined the in fluence of positive test results on women's experiences of pregnancy. Methods: The study population was all 67 pregnant women who received a positive result on serum screening in two Finnish towns from Septembe r 1993 to March 1994. For each case woman a control woman, matched for age, parity, education, and previous miscarriages, was selected. Of t hose invited, 45 case women and 46 control women (79%) responded to se mistructured interviews. Results: Of the 45 case women, 2 underwent te rmination of pregnancy after the diagnosis of an abnormality and I had a miscarriage. Of the remaining 42, 7 decided not to undergo further diagnostic tests, for 2 women the second serum test was normal, and 33 had amniocentesis or chorionic villus sampling. The positive screenin g result and wait for the final results negatively affected the emotio nal well-being of most of these 33 women, and 6 were still worried aft er receiving final reassuring results. Of the 46 control women, 17 fel t some worry or fear regarding abnormality in their fetus. Conclusion: The significant negative psychosocial effects of serum screening shou ld be taken into account by caregivers when deciding whether and how t o institutionalize these tests as part of antenatal care.