Priest J H, FitzGerald J M, Haag M M, Streets K, Vanisko M, Johnson J P
Shodair Hospital, Genetics Laboratory, Helena, Montana, USA.
J Med Screen. 1998;5(4):178-82. doi: 10.1136/jms.5.4.178.
To assess factors influencing uptake of amniocentesis after a positive Down's syndrome screening result.
Interviews of 53 Montana women with screening risks > or = 1 in 300 after delivery.
Thirty had accepted amniocentesis ("yes" group) and 23 had declined ("no" group) (57% uptake). Age at delivery was significantly higher (p = 0.02) for the "no" than the "yes" group (mean 35.3 nu 31.7 years). The mean risk of Down's syndrome ascertained by screening was 1 in 190 for the "no" group and 1 in 115 for the "yes" group (p = 0.05). Statistically significant differences (p < or = 0.05) between opinions in the two groups included: (a) desire to know if the fetus had Down's syndrome; (b) perception of the burden of care for an affected child; (c) support of doctor, spouse, and relatives for choice about amniocentesis; (d) attitudes toward abortion; (e) importance of religion; and (f) concerns about the amniocentesis procedure. The most important factor for those choosing amniocentesis was knowing if the fetus had Down's syndrome, and for those not choosing amniocentesis, attitude about abortion.
Our results show the need for prescreening education to enable pregnant women to make informed decisions about screening for Down's syndrome and diagnostic testing.
评估唐氏综合征筛查结果呈阳性后影响羊膜穿刺术接受率的因素。
对53名蒙大拿州产后筛查风险≥1/300的女性进行访谈。
30人接受了羊膜穿刺术（“是”组），23人拒绝（“否”组）（接受率57%）。“否”组的分娩年龄显著高于“是”组（p = 0.02）（平均35.3岁对31.7岁）。“否”组经筛查确定的唐氏综合征平均风险为1/190，“是”组为1/115（p = 0.05）。两组意见之间具有统计学显著差异（p≤0.05），包括：（a）想知道胎儿是否患有唐氏综合征；（b）对照顾患病儿童负担的认知；（c）医生、配偶和亲属对羊膜穿刺术选择的支持；（d）对堕胎的态度；（e）宗教的重要性；（f）对羊膜穿刺术程序的担忧。选择羊膜穿刺术的人最重要的因素是知道胎儿是否患有唐氏综合征，而不选择的人最重要的因素是对堕胎的态度。
我们的结果表明需要进行预筛查教育，以使孕妇能够就唐氏综合征筛查和诊断检测做出明智的决定。
