Women's attitudes to the successive decisions possibly involved in prenatal screening for Down syndrome: how consistent with their actual decisions?

Abstract

To investigate women's attitudes to successive decisions possibly involved in Down syndrome screening (i.e. about ultrasound and biochemical screening, invasive testing, and termination of pregnancy) and to compare attitudes and actual decisions. Four hundred women were invited to complete a self-administered questionnaire within 3 days postpartum. A hierarchical cluster analysis identified respondents with similar attitudes, and logistic regressions assessed the effects of factors relating to decision-making on attitudes. Three hundred and ninety-one women returned the questionnaire. Three clusters of women were identified. Two clusters comprised respondents stating that decision-making should be based on attitudes to either termination of pregnancy (32.8%) or invasive testing-related miscarriage (30.2%). The third cluster (37.0%) considered that obtaining information about pregnancy should be the main objective when deciding about biochemical screening or invasive testing. Multivariate logistic regressions showed some consistency between attitudes and previous decisions. Providing information and eliciting women's attitudes towards the sequence of decisions possibly involved in Down syndrome screening could help them make their decisions about screening and/or invasive testing in line with their attitudes.