Chan Yiu Man, Leung Tse Ngong, Leung Tak Yeung, Fung Tak Yuen, Chan Lin Wai, Lau Tze Kin
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Prenat Diagn. 2006 Sep;26(9):819-24. doi: 10.1002/pd.1511.
This study was performed to investigate the preferences of Chinese pregnant women for Down syndrome-affected birth compared to invasive test-related miscarriage, using the standard gamble approach, and to investigate whether there is a difference in Utility Score between general obstetric patients and those who request prenatal screening.
An interviewer-administered survey was conducted on 67 women who presented to the General Obstetric Clinic for booking visits and 69 women who presented to the first-trimester Combined Screening Clinic for fetal Down syndrome in a University Obstetric Unit. Preferences for Down syndrome-affected birth compared to invasive test-related miscarriage were assessed using the standard gamble approach. The differences in Utility Scores for the two outcomes and difference in scores between the two study groups were compared.
There was no significant difference in any of the Utility Scores studied between the two study groups. Therefore the summary statistics were performed using the whole study population. The median Utility Score for a Down syndrome-birth was 0.20 (IQR: 0.10-0.40), which was significantly lower than that of 0.55 (IQR: 0.40-0.80) for a procedure-related miscarriage (p < 0.001). Also, the Utility Scores were neither found to be associated with any particular patient demographic characteristics nor their perception of the functional disability of individuals with Down syndrome.
The Chinese pregnant women in Hong Kong consider a Down syndrome-affected birth as a much worse health state and life event than a miscarriage. Whether or not to have a screening test appeared to be a result of accessibility and affordability rather than fundamental differences in attitude towards Down syndrome. The findings of the study provide important information on how prenatal screening and diagnosis of fetal chromosomal abnormalities should be offered.
本研究采用标准博弈法，调查中国孕妇相较于侵入性检测相关流产，对唐氏综合征患儿出生的偏好，并调查普通产科患者与要求进行产前筛查的患者在效用得分上是否存在差异。
对在大学产科单位普通产科门诊进行预约就诊的67名女性和在孕早期联合筛查门诊进行胎儿唐氏综合征筛查的69名女性进行了访谈式调查。采用标准博弈法评估相较于侵入性检测相关流产，对唐氏综合征患儿出生的偏好。比较了两种结果的效用得分差异以及两个研究组之间的得分差异。
两个研究组在所研究的任何效用得分上均无显著差异。因此，使用整个研究人群进行了汇总统计。唐氏综合征患儿出生的效用得分中位数为0.20（四分位间距：0.10 - 0.40），显著低于与操作相关流产的0.55（四分位间距：0.40 - 0.80）（p < 0.001）。此外，未发现效用得分与任何特定患者人口统计学特征或他们对唐氏综合征患者功能残疾的认知相关。
香港的中国孕妇认为唐氏综合征患儿出生是比流产更糟糕的健康状况和生活事件。是否进行筛查似乎是可及性和可承受性的结果，而非对唐氏综合征态度上的根本差异。该研究结果为如何提供胎儿染色体异常的产前筛查和诊断提供了重要信息。
