title: Participation in maternal serum screening for Down syndrome, neural tube defects, and trisomy 18 following screen-positive results in a previous pregnancy.
abstract: OBJECTIVE
  To determine whether women who have had a positive serum screening result for Down syndrome or neural tube defect in 1 pregnancy have a lower rate of participation in screening in their next pregnancy.
  
  
  METHODS
  A triple-marker screening program at a university hospital.
  
  
  METHODS
  Pregnancy and screening information was collected from laboratory and hospital databases to compare subsequent screening participation of women who were screen-negative and screen-positive for the risk of a fetus with Down syndrome or a neural tube defect.
  
  
  RESULTS
  In an age-matched comparison, 108 women who had a previous screen-positive result were significantly less likely than 108 women who were screen-negative to participate in maternal serum screening in their next pregnancy. When examined according to the type of screen-positive result, the effect was significant for both those who were screen-positive for Down syndrome and those who were screen-positive for neural tube defect. The degree of risk in screen-positive women did not significantly affect their participation in screening in the next pregnancy.
  
  
  CONCLUSIONS
  Anxiety related to a screen-positive result probably causes decreased participation in maternal serum screening in the next pregnancy. Reducing the screen-positive rate in prenatal serum screening would alleviate maternal anxiety and would probably lead to more stable participation.
authors.affiliation: Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Brown University School of Medicine, 70 Elm St, Providence, RI 02903, USA.
authors.forename: D N
authors.initials: DN
authors.lastname: Rausch
authors.forename: G M
authors.initials: GM
authors.lastname: Lambert-Messerlian
authors.forename: J A
authors.initials: JA
authors.lastname: Canick
mesh_terms: D001007:Anxiety; D015415:Biomarkers / Q000097:blood*; D016009:Chi-Square Distribution; D006063:Chorionic Gonadotropin / Q000097:blood; D002887:Chromosomes, Human, Pair 18; D004314:Down Syndrome / Q000175:diagnosis*; D004964:Estriol / Q000097:blood; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D009436:Neural Tube Defects / Q000175:diagnosis*; D010358:Patient Participation; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods* / Q000523:psychology; D014314:Trisomy / Q000175:diagnosis*; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins; D004964:Estriol