PSYCHOLOGICAL OUTCOMES FOLLOWING MATERNAL SERUM SCREENING - A COHORT STUDY

Background: Maternal serum screening is used to assist in the prenatal detection of congenital anomalies. Its use is controversial, and one concern that has been expressed is its psychological effects on women. The authors examined whether this test leads to an increase in anxiet y and depression among women who have a false-positive result as compa red with those who have a true-negative result or do not undergo testi ng. Methods: A prospective cohort study with baseline assessment at 15 to 18 weeks' gestation and follow-up at 24 weeks' gestation was condu cted. Pregnant women at 8 geographically diverse sites across Ontario were recruited. The main outcome measures were the state portion of th e State-Trait Anxiety Inventory and the Center for Epidemiologic Studi es Depression Scale. Results: Of the 2418 potential subjects 2020 (83. 5%) were enrolled and eligible; 1741 (86.2%) completed the follow-up. A total of 1177 women (67.6%) underwent maternal serum screening. No o verall adverse psychological effects as a result of testing were found at 24 weeks' gestation. Women with a false-positive result had a mean increase in anxiety score of 1.6 (95% confidence interval [CI] -1.7 t o 4.9), whereas women with a true-negative result had a mean decrease of 1.1 (95% CI -1.8 to -0.3) and those not tested had a mean decrease of 0.4 (95% CI -1.3 to 0.5). The mean depression score increased by 0. 5 (95% CI -0.9 to 2.0) in the false-positive group, was unchanged (95% CI -0.3 to 0.4) in the true-negative group and increased by 0.2 (95% CI -1.7 to 1.2) in the not tested group. Of the women who underwent te sting, 87 (7.6%) were unsure of their result at the time of follow-up. Interpretation: The results suggest that maternal serum screening In Ontario is not causing serious psychological harm to women. Communicat ion regarding test results could he improved, since a substantial prop ortion of women were unsure of their test result.