title: Women's attitude towards routine human platelet antigen-screening in pregnancy.
abstract: BACKGROUND
  Fetal and neonatal alloimmune thrombocytopenia is a potentially life-threatening disease with excellent preventative treatment available for subsequent pregnancies. To prevent index cases, the effectiveness of a population-based screening program has been suggested repeatedly. Therefore, we aimed to evaluate women's attitude towards possible future human platelet antigen-screening in pregnancy.
  
  
  METHODS
  We performed a cross-sectional questionnaire study among healthy pregnant women receiving prenatal care in one of seven participating midwifery practices. Attitude was assessed using a questionnaire based on the validated Multidimensional Measurement of Informed Choice model, containing questions assessing knowledge, attitude and intention to participate.
  
  
  RESULTS
  A total of 143 of the 220 women (65%) completed and returned the questionnaire. A positive attitude towards human platelet antigen-screening was expressed by 91% of participants, of which 94% was based on sufficient knowledge. Attitude was more likely to be negatively influenced by the opinion that screening can be frightening. Informed choices were made in 87% and occurred significantly less in women from non-European origin, 89% in European women vs. 60% in non-European women (p = 0.03).
  
  
  CONCLUSIONS
  Pregnant women in the Netherlands expressed a positive attitude towards human platelet antigen-screening in pregnancy. We therefore expect a high rate of informed uptake when human platelet antigen-screening is implemented. In future counseling on human platelet antigen-screening, ethnicity and possible anxiety associated with a screening test need to be specifically addressed.
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.|Department Immunohematology Diagnostics, Sanquin, Amsterdam, The Netherlands.
authors.forename: Dian
authors.identifier: http://orcid.org/0000-0002-6538-5752
authors.initials: D
authors.lastname: Winkelhorst
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Rosanne M
authors.initials: RM
authors.lastname: Loeff
authors.affiliation: Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M Elske
authors.initials: ME
authors.lastname: van den Akker-Van Marle
authors.affiliation: Department Immunohematology Diagnostics, Sanquin, Amsterdam, The Netherlands.|Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Masja
authors.initials: M
authors.lastname: de Haas
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Dick
authors.initials: D
authors.lastname: Oepkes
mesh_terms: D000328:Adult; D016824:Antigens, Human Platelet / Q000235:genetics; D003430:Cross-Sectional Studies; D005260:Female; D005820:Genetic Testing; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008880:Midwifery / Q000706:statistics & numerical data; D009426:Netherlands; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011795:Surveys and Questionnaires; D054098:Thrombocytopenia, Neonatal Alloimmune / Q000175:diagnosis* / Q000235:genetics
chemical_list: D016824:Antigens, Human Platelet
keywords: Screening; attitude; fetal and neonatal alloimmune thrombocytopenia; human platelet antigen; informed choice; questionnaire