A RANDOMIZED TRIAL OF 3 METHODS OF GIVING INFORMATION ABOUT PRENATAL TESTING

Objective-To test the effect of extra nondirective information about p renatal testing, given individually or in a class. Setting-Antenatal c linics in a district general hospital and a university hospital. Desig n-Randomised controlled trial; participants allocated to control group or offer of extra information individually or in class. Subjects-1691 women booking antenatal care before 15 weeks' gestation. Intervention s-All participants received the usual information about prenatal tests from hospital staff. Individual participants were offered a separate session with a research midwife in which prenatal screening was descri bed in detail. Class participants were offered the same extra informat ion in an early prenatal class. Main outcome measures-Attendance at ex tra information sessions; uptake rates of prenatal tests; levels of an xiety, understanding, and satisfaction with decisions. Results-Attenda nce at classes was lower than at individual sessions (adjusted odds ra tio 0.45; 95% confidence interval 0.35 to 0.58). Ultrasonography was a lmost universally accepted (99%) and was not affected by either interv ention. Uptake of cystic fibrosis testing, high in controls (79%), was lowered in the individual group (0.44; 0.20 to 0.97) and classes (0.3 9; 0.18 to 0.86). Uptake of screening for Down's syndrome, alreaay low (34%) in controls, was not further depressed by extra information in classes (0.99; 0.70 to 1.39) and was slightly higher in the individual group (1.45; 1.04 to 2.02). Women offered extra information had impro ved understanding and were more satisfied with information received; s atisfaction with decisions about prenatal testing was unchanged. The o ffer of individual information reduced anxiety later in pregnancy. Con clusions-Ultrasonography is valued for nonmedical reasons and chosen e ven by fully informed people who eschew prenatal diagnosis. The offer of extra information has no overall adverse effects on anxiety and red uces uptake of blood tests when background uptake rate is high (but no t when it is already low). High uptake of prenatal blood tests suggest s compliant behaviour and need for more information.