Assessing the psychological effects of prenatal screening tests for maternal and foetal conditions: a systematic review

Abstract

Background: Foetal medicine advancements have increased the variety of prenatal screening tests that can be offered to women. Prenatal screening tests may have positive or negative effects for women. This systematic review aims to review the published literature to determine the psychological effects of prenatal screening tests for conditions that affect the mother, as compared to screening tests for conditions that affect the foetus. Method: Seven electronic databases were searched for research reports on the emotional, behavioural and cognitive effects of prenatal screening tests published in the English language before 1 December 2011. Studies of diagnosed conditions, rather than screening tests, were excluded. Results: 18 studies investigated screening tests with maternal health implications and 33 studies and 4 reviews investigated tests with foetal health implications. While tests with foetal health implications were associated with increases in maternal anxiety, tests with maternal health implications were not. Neither were associated with behavioural outcomes. Both types of test were associated with cognitive outcomes such as increased maternal responsibility and negative perceptions of health. Conclusions: This review found that women experienced greater anxiety following prenatal screening tests that had an impact on foetal health compared with those that had an impact on maternal health. However, this is based on relatively few studies and there is a need to evaluate the impact of such screening tests before they are clinically introduced on a large scale.

Keywords:

• prenatal screening
• psychological effects of screening
• prenatal attachment
• cognitions
• behaviours
• emotions

Acknowledgements

We would like to thank authors who responded to requests for further data and to the information scientist and other experts that helped with the search criteria. We would also like to thank the anonymous reviewers whose suggestions strengthened this manuscript. Finally, we thank Lorna Hobbs for assistance with selecting studies and data checking.