Prenatal diagnosis tests and women’s risk perception: a cross-sectional study

Abstract

Objective: To investigate women’s decision to undergo non-invasive and/or invasive tests for prenatal diagnosis depending on the procedure-related risk and the risk of carrying a foetus with Down syndrome (DS). Both risks are rated in terms of numerical relevance and acceptability.

Method: A sample of 448 consecutive women with low-risk pregnancies were interviewed to collect social and clinical variables and to determine their perceptions of the risks of invasive procedure-related miscarriage and carrying a foetus with DS. The risks were scored numerically in terms of their relevance and acceptability using a 10-point rating scale.

Results: The factors related to the use of non-invasive tests were age ≥35 years, not being treated at a public service, rating the risk of carrying a foetus with DS as having high numerical relevance and low acceptability, and rating the risk of miscarriage as having high acceptability. These relationships were still present when the use of invasive tests was considered, except in terms of the numerical relevance of the risk of carrying a foetus with DS.

Conclusion: Perceived acceptability affects the interpretation of a given risk more than the numerical relevance of the risk.

Keywords:

• Acceptability
• counselling
• decision-making
• Down syndrome
• informed decision
• prenatal screening
• risk communication
• risk perception

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Current knowledge on the subject

• The perceived risks of both carrying a DS-affected foetus and having a procedure-related miscarriage were associated with the inclination to undergo invasive prenatal diagnostic procedures.

• The risk of carrying a foetus with DS may seem high or low depending on several factors that influence the subjective perception.

What this study adds

• In addition to the numerical relevance of the risks, the degree of acceptability a main factor involved in the decision to undergo tests for the prenatal diagnosis of DS

• The issue of acceptability should be a key focus in the counselling communication

• Improved health care provider communication could be obtained by focussing more on acceptability than on the numerical value of risks