Women's experiences of prenatal serum screening

Maternal serum screening is used to detect pregnancies at risk for Down syndrome and neural tube defects, but most positive test results (6.6% of all) are false positives. This study examined the influence of positive test results on women's experiences of pregnancy.

The study population was all 67 pregnant women who received a positive result on serum screening in two Finnish towns from September 1993 to March 1994. For each case woman a control woman, matched for age, parity, education, and previous miscarriages, was selected. Of those invited, 45 case women and 46 control women (79%) responded to semistructured interviews.

Of the 45 case women, 2 underwent termination of pregnancy after the diagnosis of an abnormality and 1 had a miscarriage. Of the remaining 42, 7 decided not to undergo further diagnostic tests, for 2 women the second serum test was normal, and 33 had amniocentesis or chorionic villus sampling. The positive screening result and wait for the final results negatively affected the emotional well-being of most of these 33 women, and 6 were still worried after receiving final reassuring results. Of the 46 control women, 17 felt some worry or fear regarding abnormality in their fetus.

The significant negative psychosocial effects of serum screening should be taken into account by caregivers when deciding whether and how to institutionalize these tests as part of antenatal care.