COPING WITH SERUM SCREENING FOR DOWN-SYNDROME WHEN THE RESULT IS GIVEN AS A NUMERIC VALUE

Forty-six pregnant women undergoing second-trimester biochemical scree ning for Down syndrome were asked to fill in the State-Trait Anxiety I nventory (STAI) questionnaire to assess their anxiety level at two dif ferent moments: when recruited to the study (at 11-13 weeks' gestation ), and after the test result was communicated. The test result was giv en as a numeric value of risk (1/x), rather than as positive/negative. There were 10 women in whom the risk after biochemical screening incr eased (median Delta risk = + 1/535; range = 1/69 to 1/1083), whereas i n the remainder the risk decreased (median Delta risk = - 1/1576; rang e = - 1/42 to - 1/4947) compared with the baseline value calculated on maternal age alone. Although only in a minority of women the STAI sco re after biochemical screening exceeded the reference range, the chang e in the STAI score was significantly higher when the risk increased, and the change in the risk estimate correlated significantly with the change in this index of anxiety. Three out of seven women with a 'nega tive' test, but increased risk estimate and increased anxiety after bi ochemical screening chose to undergo amniocentesis. A policy of provid ing the result of biochemical screening for Down syndrome as a numeric value, even for 'negative' tests, may cause some women to experience anxiety and request amniocentesis. (C) 1998 John Wiley & Sons, Ltd.