Marini Tina, Sullivan Jan, Naeem Rizwan
Baystate Medical Center, Laboratory Genetics, Western Campus Tuft Medical School, Springfield, Massachusetts, USA.
Am J Med Genet. 2002 May 1;109(3):171-5. doi: 10.1002/ajmg.10319.
We evaluated the prenatal diagnosis utilization patterns of advanced maternal age (AMA) patients who underwent serum screening to assess how screening results correlated with their decisions regarding amniocentesis. A 6-year review (1994-1999) of laboratory records identified 2,456 AMA patients who underwent multiple-marker serum screening. The relationship between screening results and patients' decisions on whether or not to undergo amniocentesis was assessed. Among the 841 AMA patients with positive screens, more than half (52%) declined amniocentesis. Of the 1,615 patients with negative serum screening results, 208 (13%) opted for amniocentesis. We concluded that decisions by AMA patients regarding amniocentesis may not always correlate clinically with maternal serum screening results. Possible explanations, including how the state of informed consent may or may not contribute to these decisions, are discussed. It is suggested that understanding the reasons for these decisions may identify opportunities for improving service delivery to all pregnant patients considering prenatal testing. Use of a questionnaire is proposed as one mechanism for gaining a clearer understanding of the possible factors contributing to AMA patient decisions.
我们评估了接受血清筛查的高龄产妇（AMA）的产前诊断利用模式，以评估筛查结果与她们关于羊膜穿刺术决策之间的相关性。对实验室记录进行的6年回顾（1994 - 1999年）确定了2456名接受多标记血清筛查的高龄产妇。评估了筛查结果与患者是否接受羊膜穿刺术决策之间的关系。在841名筛查结果为阳性的高龄产妇中，超过一半（52%）拒绝了羊膜穿刺术。在1615名血清筛查结果为阴性的患者中，208名（13%）选择了羊膜穿刺术。我们得出结论，高龄产妇关于羊膜穿刺术的决策在临床上可能并不总是与母体血清筛查结果相关。讨论了可能的解释，包括知情同意的状态如何可能或不可能促成这些决策。建议了解这些决策的原因可能会发现改善向所有考虑产前检测的孕妇提供服务的机会。建议使用问卷作为一种机制，以更清楚地了解可能促成高龄产妇决策的因素。
