Hall S, Bobrow M, Marteau T M
Psychology and Genetics Research Group, Guy's, King's College, and St Thomas's School of Medicine, Thomas Guy House, Guy's Campus, London SE1 9RT.
BMJ. 2000 Feb 12;320(7232):407-12.
To determine the psychological consequences for parents of children with Down's syndrome of having received a false negative result on prenatal screening.
Comparison of adjustment of parents who received a false negative result with that of parents not offered a test and those who declined a test.
Parents were interviewed in their own homes.
Parents of 179 children with Down's syndrome (mean age 4 (range 2-6) years).
Anxiety, depression, parenting stress, attitudes towards the child, and attributions of blame for the birth of the affected child.
Overall, regardless of screening history, parents adjusted well to having a child with Down's syndrome. Compared with mothers who declined a test, mothers in the false negative group had higher parenting stress (mean score 81.2 v 71.8, P=0.016, 95% confidence interval for the difference 1.8 to 17.0) and more negative attitudes towards their children (124.9 v 134.2, P=0. 009, -16.2 to -2.4). Fathers in the false negative group had higher parenting stress test scores (77.8 v 70.0, P=0.046, 1.5 to 14.2) than fathers not offered a test. Mothers in the false negative group were more likely to blame others for the outcome than mothers who had not been offered the test (28% v 13%, P=0.032, 3% to 27%). Mothers and fathers in the false negative group were more likely to blame others for this outcome than parents who had declined a test (mothers 28% v 0%, P=0.001, 19% to 37%; fathers 27% v 0%, P=0.004, 17% to 38%). Blaming others was associated with poorer adjustment for mothers and fathers.
A false negative result on prenatal screening seems to have a small adverse effect on parental adjustment evident two to six years after the birth of an affected child.
确定唐氏综合征患儿的父母因产前筛查结果为假阴性而产生的心理影响。
比较收到假阴性结果的父母与未接受检测的父母以及拒绝检测的父母的心理调适情况。
在父母家中进行访谈。
179名唐氏综合征患儿的父母(平均年龄4岁(范围2 - 6岁))。
焦虑、抑郁、育儿压力、对孩子的态度以及对患儿出生的责任归咎。
总体而言,无论筛查史如何,父母对患有唐氏综合征的孩子都调适良好。与拒绝检测的母亲相比,假阴性组的母亲育儿压力更高(平均得分81.2对71.8,P = 0.016,差异的95%置信区间为1.8至17.0),对孩子的态度更消极(124.9对134.2,P = 0.009,-16.2至-2.4)。假阴性组的父亲育儿压力测试得分高于未接受检测的父亲(77.8对70.0,P = 0.046,1.5至14.2)。假阴性组的母亲比未接受检测的母亲更倾向于将结果归咎于他人(28%对13%,P = 0.032,3%至27%)。假阴性组的母亲和父亲比拒绝检测的父母更倾向于将此结果归咎于他人(母亲28%对0%,P = 0.001,19%至37%;父亲27%对0%,P = 0.004,17%至38%)。归咎于他人与父母较差的心理调适相关。
产前筛查的假阴性结果似乎对患儿出生两至六年后父母的心理调适有轻微不利影响。