Grinshpun-Cohen Julia, Miron-Shatz Talya, Rhee-Morris Laila, Briscoe Barbara, Pras Elon, Towner Dena
a Department of OB/GYN , University of California Davis Medical Center , Sacramento , California , USA.
J Health Commun. 2015;20(9):1107-13. doi: 10.1080/10810730.2015.1018632. Epub 2015 Jun 11.
Amniocentesis is an invasive procedure performed during pregnancy to determine, among other things, whether the fetus has Down syndrome. It is often preceded by screening, which gives a probabilistic risk assessment. Thus, ample information is conveyed to women with the goal to inform their decisions. This study examined the factors that predict amniocentesis uptake among pregnant women of advanced maternal age (older than 35 years old at the time of childbirth). Participants filled out a questionnaire regarding risk estimates, demographics, and attitudes on screening and pregnancy termination before their first genetic counseling appointment and were followed up to 24 weeks of gestation. Findings show that women's decisions are not always informed by screening results or having a medical indication. Psychological factors measured at the beginning of pregnancy: amniocentesis risk tolerance, pregnancy termination tolerance, and age risk perception affected amniocentesis uptake. Although most women thought that screening for Down syndrome risk would inform their decision, they later stated other reasons for screening, such as preparing for the possibility of a child with special needs. Findings suggest that women's decisions regarding amniocentesis are driven not only by medical factors, but also by a priori attitudes. The authors believe that these should be addressed in the dialogue on women's informed use of prenatal tests.
羊膜穿刺术是一种在孕期进行的侵入性检查，除其他事项外，用于确定胎儿是否患有唐氏综合征。在此之前通常会进行筛查，筛查会给出一个概率性的风险评估。因此，会向女性传达充足的信息，目的是为她们的决策提供依据。本研究调查了预测高龄孕妇（分娩时年龄超过35岁）接受羊膜穿刺术的因素。参与者在首次遗传咨询预约前填写了一份关于风险评估、人口统计学以及对筛查和终止妊娠态度的问卷，并随访至妊娠24周。研究结果表明，女性的决策并不总是受筛查结果或医学指征的影响。妊娠初期测量的心理因素：羊膜穿刺术风险耐受性、终止妊娠耐受性和年龄风险认知会影响羊膜穿刺术的接受情况。尽管大多数女性认为唐氏综合征风险筛查会为她们的决策提供依据，但她们后来又提到了其他筛查原因，比如为可能生育有特殊需求的孩子做准备。研究结果表明，女性关于羊膜穿刺术的决策不仅受医学因素驱动，还受先验态度的影响。作者认为，在关于女性明智使用产前检查的讨论中应解决这些问题。
