Abstract
Maternal serum screening for fetal Down syndrome has been integrated into routine antenatal care in most clinics in Taiwan. We examined the attitudes toward serum screening and the possible implications in women with positive results. From January to July 1995, 276 women were referred to the Genetic Counseling Clinic, Mackay Memorial Hospital for amniocentesis because of positive screening results, and 214 participated in this study. All women opted for amniocentesis after genetic counseling. Over 40% stated that they made decisions independently after being informed of the serum screening. Need for certainty was the most frequently mentioned reason. Two-thirds believed that serum screening could provide a diagnosis. Almost all women would apply for maternal serum screening for future pregnancies. This study demonstrated that Chinese women need more counseling and autonomy regarding maternal serum screening.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adams MJ, Jr, Windham GC, James LM, Greenberg F, Clayton-Hopkins JA, Reimer CB, Oakley GP, Jr (1984) Clinical interpretations of maternal serum alpha-fetoprotein concentrations.Am J Obstet Gynecol 148(3):241–254.
Abuelo DN, Hopmann MR, Barsel-Bowers G, Goldstein A (1991) Anxiety in women with low maternal serum alpha-fetoprotein screening results.Prenat Diagn 11:381–385.
Beekhuis JR, De Wolf BTHM, Mantingh A, Heringa MP (1994) The influence of serum screening on the amniocentesis rate in women of advanced maternal age.Prenat Diagn 14:199–202.
Bogart MH, Pandian MR, Jones OW (1987) Abnormal maternal serum chorionic gonadotropin levels in pregnancies with fetal chromosomal abnormalities.Prenat Diagn 7:623–630.
Burton BK, Dillard RG, Clark EN (1985a) The psychological impact of false positive elevations of maternal serum α-fetoprotein.Am J Obstet Gynecol 151:77–82.
Burton BK, Dillard RG, Clark EN (1985b) Maternal serum α-fetoprotein screening: The effect of participation on anxiety and attitude toward pregnancy in women with normal results.Am J Obstet Gynecol 152:540–543.
Canick JA, Knight GJ, Palomaki GE, Haddow JE, Cuckle HS, Wald NJ (1988) Low second trimester maternal serum unconjugated oestriol in pregnancies with Down's syndrome.Br J Obstet Gynecol 95(4):330–333.
Chow HJ (1996)Handbook of Prenatal Care. Taipei: Lian-Ching Press.
Drugan A, Dvorin E, Koppitch FC, 3rd, Greb A, Krivchenia EL, Evans MI (1989) Counseling for low maternal serum alpha-fetoprotein should emphasize all chromosome anomalies, not just Down syndrome.Obstet Gynecol 73(2):271–274.
Evans MI, Bottoms SF, Carlucci T, Grant J, Belsky RL, Solyom AE, Quigg MH, LaFerla JJ (1988) Determinants of altered anxiety after abnormal maternal serum α-fetoprotein screening.Am J Obstet Gynecol 159:1501–1504.
Haddow JE, Palomaki GE, Knight GJ, Cunningham GC, Lustig LS, Boyd PA (1994) Reducing the need for amniocentesis in women 35 years of age or older with serum markers for screening.N Engl J Med 330(16):1114–1118.
Kamerbeek LI, Roelofsen EE, Beekhuis JR., Tijmstra T, Mantingh A (1993) How women cope with the results of maternal serum screening for fetal neural tube defects and Down syndrome (Dutch).Nederlands Tijdschrift voor Geneeskunde 137(26):1308–1311.
Kellner LH, Weiss RR, Weiner Z, Neuer M, Martin GM, Schulman H, Lipper S (1995) The advantages of using triple-marker screening for chromosomal abnormalities.Am J Obstet Gynecol 172(3):831–836.
Kidd J, Cook R, Marteau TM (1993) Is routine AFP screening in pregnancy reassuring?J Psychosomat Res 37:717–722.
Knight GJ, Palomaki GE (1992) Maternal serum alpha-fetoprotein and the detection of open neural tube defects. In: Elias S, Simpson JL (ed)Maternal Serum Screening for Fetal Genetic Disorders. New York: Churchill Livingstone, pp 41–58.
Marteau TM, Cook R, Kidd J, Michie S, Johnston M, Slack J, Shaw RW (1992) The psychological effects of false-positive results in prenatal screening for fetal abnormality: A prospective study.Prenat Diagn 12:205–214.
Merkatz IR, Nitowsky HM, Macri JN, Johnson WE (1984) An association between low maternal serum alpha-fetoprotein and fetal chromosomal abnormalities.Am J Obstet Gynecol 148:886–891.
Milunsky A, Nebiolo L (1992) Screening for chromosome defects in the first and second trimesters of pregnancy. In: Elias S, Simpson JL (ed)Maternal Serum Screening for Fetal Genetic Disorders. New York: Churchill Livingstone, pp 75–85.
Mooney RA, Peterson CJ, French CA, Saller DN, Jr, Arvan DA (1994) Effectiveness of combining maternal serum alpha-fetoprotein and hCG in a second-trimester screening program for Down syndrome.Obstet Gynecol 84(2):298–303.
New England Regional Genetics Group Prenatal Collaborative Study of Down Syndrome Screening (1989) Combining maternal serum alpha-fetoprotein measurements and age to screen for Down syndrome in pregnant women under age 35.Am J Obstet Gynecol 160:575–581.
Palomaki GE, Hill LE, Knight GJ, Haddow JE, Carpenter M (1988) Second trimester maternal serum alpha-fetoprotein levels in pregnancies associated with gastroschisis and omphalocele.Obstet Gynecol 71(6, pt. 1):906–909.
Palomaki GE, Knight GJ, Holman MS, Haddow JE (1990) Maternal serum α-fetoprotein screening for fetal Down syndrome in the United States: Results of a survey.Am J Obstet Gynecol 162:317–321.
Reynolds T, John R (1992) Comparison of assay kits for unconjugated estriol shows that expressing results as multiples of the median causes unacceptable variation in calculated risk factors for Down syndrome.Clin Chem 38:1888–1893.
Roelofsen EEC, Kamerbeek LI, Tymstra TJ, Beekhuis JR, Mantingh A (1993) Women's opinions on the offer and use of maternal serum screening.Prenat Diagn 13:741–747.
Rose NC, Palomaki GE, Haddow JE, Goodman DBP, Mennuti MT (1994) Maternal serum α-fetoprotein screening for chromosomal abnormalities: A prospective study in women aged 35 and older.Am J Obstet Gynecol 170:1073–1080.
Sanden ML, Bjurulf P (1988) Pregnant women's attitudes for accepting or declining a serum-alpha-fetoprotein test.Scand J Soc Med 16(4):265–271.
Sikkink J (1990) Patient acceptance of prenatal alpha-fetoprotein screening: A preliminary study.Fam Pract Res J 10(2):123–131.
Sjogren B, Uddenberg N (1988) Decision making during the prenatal diagnostic procedure. A questionnaire and interview study of 211 women participating in prenatal diagnosis.Prenat Diagn 8:263–273.
Spencer K (1994) Is the measurement of unconjugated oestriol of value in screening for Down's syndrome. In: Grudzinskas JG, Chard T, Chapman M, Cuckle H (ed)Screening for Down's Syndrome. New York: Cambridge Press, pp 141–61.
The Society of Perinatology, ROC (1993) Congenital Malformation in Taiwan: Background, Prenatal Diagnosis, Postnatal Management. 1993 Annual Report, Department of Health Press, Taipai.
The Society of Perinatology, ROC (1995) Report from Taiwan Down Syndrome Screening Group. Department of Health Press, Taipai (not published).
Wald NJ, Cuckle HS, Densem JW, Nanchahal K, Royston P, Chard T, Haddow JE, Knight GJ, Palomaki GE, Canick JA (1988) Maternal serum screening for Down's syndrome in early pregnancy.Br Med J 297(6653):883–887.
Wald NJ, Kennard A. Densem JW. Cuckle HS, Chard T, Butler L (1992) Antenatal maternal serum screening for Down's syndrome: Results of a demonstration project.Br Med J 305(6850):391–394.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jan, SW., Chen, CP., Huang, LH. et al. Attitudes toward maternal serum screening in Chinese women with positive results. J Genet Counsel 5, 169–180 (1996). https://doi.org/10.1007/BF01408371
Issue Date:
DOI: https://doi.org/10.1007/BF01408371