Qualitative investigation of the factors that generate ambivalent feelings in women who give birth after receiving negative results from non-invasive prenatal testing

Junko Yotsumoto,Masaki Ogawa,Yuki Katagiri ,Yoko Okamoto,Tatsuru Kaji ,Jun Murotsuki,Kiyonori Miura,Akira Sasaki ,Nobuhiro Suzumori,Akihiko Sekizawa,Haruki Nishizawa,Takayoshi Ohba ,Keiichi Matsubara,Akimune Fukushima,Yoshimasa Kamei,Yukie Kawano,Hideaki Sawai,Keisuke Maeda ,Osamu Samura,Naoki Takeshita,Hiroaki Masuzaki ,Satomi Inoue,Takahiro Yamada,Hiroyuki Osada ,Shinya Tairaku,Haruka Hamanoue,Toshiaki Endo,Masanobu Ogawa,Haruhiko Sago

doi:10.1186/s12884-020-2763-z

Abstract

BackgroundWomen who receive negative results from non-invasive prenatal genetic testing (NIPT) may find that they later have mixed or ambivalent feelings, for example, feelings of accepting NIPT and regretting undergoing the test. This study aimed to investigate the factors generating ambivalent feelings among women who gave birth after having received negative results from NIPT.MethodsA questionnaire was sent to women who received a negative NIPT result, and a contents analysis was conducted focusing on ambivalent expressions for those 1562 women who responded the questionnaire. The qualitative data gathered from the questionnaire were analyzed using the N-Vivo software package.ResultsEnvironmental factors, genetic counseling-related factors, and increased anticipatory anxiety, affected the feeling of ambivalence among pregnant women. Furthermore, pregnant women desired more information regarding the detailed prognosis for individuals with Down syndrome and living with them and/or termination, assuming the possibility that they were positive.ConclusionsThree major interrelated factors affected the feeling of ambivalence in women. Highlighting and discussing such factors during genetic counseling may resolve some of these ambivalences, thereby enhancing the quality of decisions made by pregnant women.

Highlights

Women who receive negative results from non-invasive prenatal genetic testing (NIPT) may find that they later have mixed or ambivalent feelings, for example, feelings of accepting NIPT and regretting undergoing the test
We identified three primary categories generating feelings of ambivalence among women: (1) factors related to genetic counseling; (2) environmental factors, and (3) increased anticipatory anxiety
The results of this study showed that factors related to genetic counseling and environmental factors greatly influence women’s decision-making regarding taking the NIPT

Summary

Introduction

Women who receive negative results from non-invasive prenatal genetic testing (NIPT) may find that they later have mixed or ambivalent feelings, for example, feelings of accepting NIPT and regretting undergoing the test. This study aimed to investigate the factors generating ambivalent feelings among women who gave birth after having received negative results from NIPT. A prenatal test for fetal abnormalities may cause maternal anxiety [1, 2]. Pregnant women who made an uninformed choice for non-invasive prenatal genetic testing (NIPT) felt deeper decisional regret associated with prolonged anxiety [3, 4]. Many women reportedly take the NIPT to relieve their ambivalence regarding negative results [5]. Ambivalence has been identified among the attitudes of the general public

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