Participation in maternal serum screening for Down syndrome, neural tube defects, and trisomy 18 following screen-positive results in a previous pregnancy

Objective To determine whether women who have had a positive serum screenin g result for Down syndrome or neural cube defect in 1 pregnancy have a lowe r rate of participation in screening in their next pregnancy. Setting A tri ple-marker screening program at a university hospital. Methods Pregnancy an d screening information was collected from laboratory and hospital database s to compare subsequent screening participation of women who were screen-ne gative and screen-positive for the risk of a fetus with Down syndrome or a neural tube defect. Results In an age-matched comparison, 108 women who had a previous screen-positive result were significantly less likely than 108 women who were screen-negative to participate in maternal serum screening i n their next pregnancy. When examined according to the type of screen-posit ive result, the effect was significant for both those who were screen-posit ive for Down syndrome and those who were screen-positive for neural tube de fect. The degree of risk in screen-positive women did not significantly aff ect their participation in screening in the next pregnancy. Conclusions Anx iety related to a screen-positive result probably causes decreased particip ation in maternal serum screening in the next pregnancy. Reducing the scree n-positive rate in prenatal serum screening would alleviate maternal anxiet y and would probably lead to more stable participation.