Prenatal screening for neural tube defects: perceptions of potential recipients

The interpretation of prenatal screening and follow-up diagnostic testing for neural tube defects is relatively complex and presents unusual demands in terms of informed utilization by pregnant women. Such demands could impact differentially on individuals of different socioeconomic status or cultural values. Accordingly, a two-part questionnaire, interrupted by presentation of educational material on neural tube defects and prenatal screening, was presented to female sophomore medical students and to reproductive-age women whose children were served at Howard University Hospital. Student subjects favored prenatal testing, whereas clinic subjects were divided on testing both before and after reading the educational material. Both groups anticipated prenatal screening in future pregnancies, but clinic subjects were ambiguous about the need for diagnostic follow-up after the determination of high maternal serum alpha-fetoprotein. Clinic subjects were more hesitant than students to employ abortion as a means of intervention and did not distinguish between spina bifida and anencephaly in this regard.