A Randomized Trial of Two Methods of Issuing Prenatal Test Results: The ARIA (Amniocentesis Results: Investigation of Anxiety) Trial

Abstract

Fetal karyotyping of cells obtained by amniocentesis may take as long as 3 weeks, and many pregnant women experience anxiety during the interval. This randomized, controlled study evaluated 2 tactics for lessening anxiety: issuing karyotyping results on a prespecified date rather than when they become available and presenting early results from a rapid molecular test before karyotyping is complete. The patient population included 226 women who had amniocentesis at 14-20 weeks' gestation because of maternal age, a serum screen risk, a single soft marker for Down syndrome, or parental anxiety. Eight women with abnormal results or test failure were excluded after randomization. The short version of the Spielberger State-Trait Anxiety Inventory was completed each day during the waiting period and again 1 month after the results of amniocentesis were disclosed. Women having a rapid test (fluorescence in situ hybridization or the polymerase chain reaction technique) exhibited significantly less anxiety during the waiting period. Analysis suggested a moderate to good reduction in anxiety. Anxiety levels did not differ significantly when results were presented on a fixed date rather than as they became available. Anxiety levels were comparatively low in all groups a month after the women had received normal karyotype results. Rapid testing, when added to karyotyping, helps to control anxiety following amniocentesis. It would be appropriate for women to choose whether to receive their results when available or at a fixed, prespecified time. The present findings do not imply that early test results should replace comprehensive prenatal testing.