Psychological responses to prenatal NTS counseling and the uptake of invasive testing in women of advanced maternal age.
This study examines women's psychological responses to prenatal group genetic counseling, and to subsequent individualized risk counseling. All women (N=123) aged 35 and older underwent nuchal translucency screening (NTS), a prenatal ultrasound screening test. After group counseling, decisional conflict decreased significantly among those reporting at baseline having made a decision about invasive testing (t(222)=2.0, P=0.014) and for those who were uncertain (t(222)=5.74, P <0.0005). After receiving NT-adjusted risks, decisional conflict decreased further for those uncertain about testing at baseline (t(222)=4.64, P <0.0005). There was no change in risk perception and anxiety after group counseling. After NT-adjusted risks were communicated, risk perception decreased significantly (t(230)=5.02, P <0.0005), as did anxiety (t(115)=7.91, P <0.005). Despite reassuring NTS results, the uptake rate for prenatal invasive testing was 78.4%. Risk perception, anxiety, and decisional conflict decreased after individual counseling for reassuring NTS results, but the uptake of invasive testing remained high.
Kaiser
Amy S
AS
Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College Street, Toronto, Ont., Canada M5T 1R8.
Ferris
Lorraine E
LE
Katz
Randy
R
Pastuszak
Anne
A
Llewellyn-Thomas
Hilary
H
Johnson
Jo-Ann
JA
Shaw
Brian F
BF
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D003220:Conflict, Psychological; D003657:Decision Making; D004522:Educational Status; D030141:Feedback, Psychological; D005260:Female; D005817:Genetic Counseling / Q000379:methods / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006801:Humans; D008423:Maternal Age; D009035:Mothers / Q000193:education / Q000523:psychology; D009864:Ontario; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D015397:Program Evaluation; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016216:Ultrasonography, Prenatal / Q000523:psychology* / Q000706:statistics & numerical data