Acceptance of amniocentesis by women in the state of Montana (USA) who arescreen positive for Down's syndrome

Objective-To assess factors influencing uptake of amniocentesis after a pos itive Down's syndrome screening result. Methods-Interviews of 53 Montana women with screening risks greater than or equal to 1 in 300 after delivery. Results-Thirty had accepted amniocentesis ("yes" group) and 23 had declined ("no" group) (57% uptake). Age at delivery was significantly higher (p=0.0 2) for the "no" than the "yes" group (mean 35.3 v 31.7 years). The mean ris k of Down's syndrome ascertained by screening was 1 in 190 for the "no" gro up and 1 in 115 for the "yes" group (p=0.05). Statistically significant dif ferences (p less than or equal to 0.05) between opinions in the two groups included: (a) desire to know if the fetus had Down's syndrome; (b) percepti on of the burden of care for an affected child; (c) support of doctor, spou se, and relatives for choice about amniocentesis; (d) attitudes toward abor tion; (e) importance of religion; and (f) concerns about the amniocentesis procedure. The most important factor for those choosing amniocentesis was k nowing if the fetus had Down's syndrome, and for those not choosing amnioce ntesis, attitude about abortion. Conclusion-Our results show the need for prescreening education to enable p regnant women to make informed decisions about screening for Dawn's syndrom e and diagnostic testing.