Acceptance of amniocentesis by women in the state of Montana (USA) who are screen positive for Down's syndrome

Abstract

Objective To assess factors influencing uptake of amniocentesis after a positive Down's syndrome screening result. Methods Interviews of 53 Montana women with screening risks ≥1 in 300 after delivery. Results Thirty had accepted amniocentesis (“yes” group) and 23 had declined (“no” group) (57% uptake). Age at delivery was significantly higher (p=0.02) for the “no” than the “yes” group (mean 35.3 v 31.7 years). The mean risk of Down's syndrome ascertained by screening was 1 in 190 for the “no” group and 1 in 115 for the “yes” group (p=0.05). Statistically significant differences (p≤0.05) between opinions in the two groups included: ( a) desire to know if the fetus had Down's syndrome; ( b) perception of the burden of care for an affected child; ( c) support of doctor, spouse, and relatives for choice about amniocentesis; ( d) attitudes toward abortion; ( e) importance of religion; and ( f) concerns about the amniocentesis procedure. The most important factor for those choosing amniocentesis was knowing if the fetus had Down's syndrome, and for those not choosing amniocentesis, attitude about abortion. Conclusion Our results show the need for prescreening education to enable pregnant women to make informed decisions about screening for Down's syndrome and diagnostic testing.