title: Variation in Women's Understanding of Prenatal Testing.
abstract: OBJECTIVE
  To investigate women's understanding of prenatal testing options and of their own experience with screening, diagnostic genetic testing, or both.
  
  
  METHODS
  This was a secondary analysis of data from a randomized controlled trial of enhanced information and values clarification regarding prenatal genetic testing in the absence of financial barriers to testing. Women in the third trimester of pregnancy were asked whether they had discussed prenatal genetic testing with their health care providers, whether they understood this testing was optional, and whether they had undergone testing during their pregnancy. Multivariable logistic regression models were fit to determine independent predictors of these outcomes.
  
  
  RESULTS
  Data were available from 710 study participants. Discussions about screening tests were reported by 654 participants (92%); only 412 (58%) reported discussing diagnostic testing. That screening and diagnostic testing were optional was evident to approximately two thirds of women (n=470 and 455, respectively). Recall of actual tests undergone was correct for 626 (88%) for screening and for 700 (99%) for diagnostic testing. Racial, ethnic and socioeconomic variation existed in the understanding of whether screening and diagnostic tests were optional and in the correct recall of whether screening had been undertaken in the current pregnancy. In the usual care group, women receiving care in low-income settings were less likely to recall being offered diagnostic testing (adjusted odds ratio 0.23 [0.14-0.39]).
  
  
  CONCLUSIONS
  Disparities exist in women's recall of prenatal genetic testing discussions and their understanding of their own experience. Interventions that explain testing options to women and help clarify their preferences may help to eliminate these differences.
authors.affiliation: Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts; and the Departments of Obstetrics, Gynecology and Reproductive Sciences, Medicine, and Epidemiology and Biostatistics, and the Medical Effectiveness Center for Diverse Populations, University of California, San Francisco, San Francisco, California.
authors.forename: Allison S
authors.initials: AS
authors.lastname: Bryant
authors.forename: Mary E
authors.initials: ME
authors.lastname: Norton
authors.forename: Sanae
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Judith T
authors.initials: JT
authors.lastname: Bishop
authors.forename: Sherri
authors.initials: S
authors.lastname: Pena
authors.forename: Steven E
authors.initials: SE
authors.lastname: Gregorich
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D003142:Communication; D003657:Decision Making; D005260:Female; D005820:Genetic Testing / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D054625:Healthcare Disparities; D006801:Humans; D011939:Mental Recall; D010358:Patient Participation; D011204:Poverty Areas; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012923:Social Class; D014481:United States; D044465:White People / Q000706:statistics & numerical data