Factors affecting women's preference for type of prenatal screening test for chromosomal anomalies

To ascertain, by means of a questionnaire, women's preferences for four different approaches to prenatal screening for Down syndrome.

Women attending antenatal clinics at six UK maternity units were asked to put in order of preference four different approaches to screening for Down syndrome all of which had the same false positive rate of 5%. The options were: (1) first-trimester testing, 90% detection of Down syndrome with results available in 1 h at one-stop clinics for the assessment of risk (OSCAR); (2) first-trimester testing, 90% detection and results available within 2-3 days (combined screening); (3) first-trimester testing plus second-trimester testing, 93% detection and results available within 2-3 days of second test (integrated testing); (4) second-trimester testing, 75% detection and results available within 2-3 days.

Over 1100 women attending antenatal clinics at six maternity units across the UK returned the questionnaire. A total of 75% of women selected a first-trimester test (option 1 or option 2) as their first choice with 68.2% expressing a preference for the OSCAR approach and a further 6.8% for combined screening. Twenty-four percent of women opted for integrated testing as their first choice with only 1% expressing a preference for second-trimester screening.

A first-trimester test is preferred by the majority of women over a test with marginally higher detection rate that delivers results later in pregnancy. Timing and rapid reporting of results appear to influence women's choice of test.