User acceptability of an alpha-fetoprotein screening programme.

The objective of the study was to determine user acceptability among women who were classified as false positives or test negatives in an alpha-fetoprotein screening programme. The study was performed as a questionnaire study over a one-year period from October 1, 1988 to September 30, 1989 at Hvidovre University Hospital, Copenhagen, and the county hospitals of Sønderjylland, Denmark. The participating subjects were 4104 pregnant women who had had an alpha-fetoprotein test and had completed 30 weeks of gestation, when the questionnaire was delivered. Main outcome measures were degree and duration of anxiety, influence on daily life and whether the woman wanted the alpha-fetoprotein test again in a new pregnancy. Three thousand, three hundred and thirty-one questionnaires were analyzed. The participation rate was 81.2%. For 219 women (6.6%), the first alpha-fetoprotein test was abnormal (high or low) and the tests were later found to be false positives. There was a strong association between anxiety experienced in conjunction with the alpha-fetoprotein screening programme and the alpha-fetoprotein test result. Two percent of the women with a normal test result reported severe anxiety, compared to 36% of the women who had an abnormal test result followed by amniocentesis (p < 0.001). Two percent of the women with a normal alpha-fetoprotein result reported that they were anxious one month or more after testing, in contrast to 39% of those who had had an amniocentesis (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)