title: Psychological responses to prenatal NTS counseling and the uptake of invasive testing in women of advanced maternal age.
abstract: 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.
authors.affiliation: Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College Street, Toronto, Ont., Canada M5T 1R8.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Kaiser
authors.forename: Lorraine E
authors.initials: LE
authors.lastname: Ferris
authors.forename: Randy
authors.initials: R
authors.lastname: Katz
authors.forename: Anne
authors.initials: A
authors.lastname: Pastuszak
authors.forename: Hilary
authors.initials: H
authors.lastname: Llewellyn-Thomas
authors.forename: Jo-Ann
authors.initials: JA
authors.lastname: Johnson
authors.forename: Brian F
authors.initials: BF
authors.lastname: Shaw
mesh_terms: 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