Women who are well informed about prenatal genetic screening delay emotional attachment to their fetus

Abstract

Background. Prenatal maternal serum screening allows assessment of risk of chromosomal abnormalities in the fetus and is increasingly being offered to all women regardless of age or prior risk. However ensuring informed choice to participate in screening is difficult and the psychological implications of making an informed decision are uncertain. The aim of this study was to compare the growth of maternal–fetal emotional attachment in groups of women whose decisions about participation in screening were informed or not informed.

Methods. A prospective longitudinal design was used. English speaking women were recruited in antenatal clinics prior to the offer of second trimester maternal screening. Three self-report questionnaires completed over the course of pregnancy used validated measures of informed choice and maternal–fetal emotional attachment. Attachment scores throughout pregnancy in informed and not-informed groups were compared in repeated measures analysis.

Results. 134 completed the first assessment (recruitment 73%) and 68 (58%) provided compete data. The informed group had significantly lower attachment scores (p = 0.023) than the not-informed group prior to testing, but scores were similar (p = 0.482) after test results were known.

Conclusion. The findings raise questions about the impact of delayed maternal–fetal attachment and appropriate interventions to facilitate informed choice to participate in screening.

Keywords:

• Prenatal genetic screening
• maternal fetal attachment
• informed decisions
• parent–child relations
• emotional aspects
• decision making