Variation in Women's Understanding of Prenatal Testing
Variation in Women's Understanding of Prenatal Testing
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DOI：
10.1097/aog.0000000000000843
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发表时间：
2015-06-01
影响因子：
7.2
通讯作者：
Kuppermann, Miriam
中科院分区：
文献类型：
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作者：
Bryant, Allison S.;Norton, Mary E.;Kuppermann, Miriam
目的：调查妇女对产前检测选择的理解以及她们自己在筛查、诊断基因检测或两者兼而有之方面的经验。方法：这是对一项随机对照试验数据的二次分析，在没有检测经济障碍的情况下，增强了关于产前基因检测的信息和价值澄清。怀孕最后三个月的妇女被问及是否与医疗保健提供者讨论过产前基因检测，是否知道这项检测是可选的，以及她们是否在怀孕期间接受过检测。多变量Logistic回归模型适合于确定这些结果的独立预测因素。结果：来自710名研究参与者的数据。654名参与者(92%)报告了关于筛查测试的讨论；只有412人(58%)报告讨论了诊断性测试。筛查和诊断测试是可选的，这一点对大约三分之二的女性来说是显而易见的(分别为470和455)。626例(88%)筛查正确，700例(99%)诊断正确。种族、民族和社会经济差异存在于对筛查和诊断测试是否是可选的理解方面，以及在正确回忆当前怀孕期间是否进行筛查方面存在差异。在常规护理组中，在低收入环境中接受护理的妇女回忆起接受诊断性检测的可能性较小(调整后的优势比0.23[0.14-0.39])。结论：妇女对产前基因检测讨论的回忆和对自身经历的理解存在差异。向女性解释测试选项并帮助澄清她们的偏好的干预措施可能有助于消除这些差异。
OBJECTIVE: To investigate women's understanding of prenatal testing options and of their own experience with screening, diagnostic genetic testing, or both.METHODS: This was a secondary analysis of data from a randomized controlled trial of enhanced information and values clarification regarding prenatal genetic testing in the absence of financial barriers to testing. Women in the third trimester of pregnancy were asked whether they had discussed prenatal genetic testing with their health care providers, whether they understood this testing was optional, and whether they had undergone testing during their pregnancy. Multivariable logistic regression models were fit to determine independent predictors of these outcomes.RESULTS: Data were available from 710 study participants. Discussions about screening tests were reported by 654 participants (92%); only 412 (58%) reported discussing diagnostic testing. That screening and diagnostic testing were optional was evident to approximately two thirds of women (n=470 and 455, respectively). Recall of actual tests undergone was correct for 626 (88%) for screening and for 700 (99%) for diagnostic testing. Racial, ethnic and socioeconomic variation existed in the understanding of whether screening and diagnostic tests were optional and in the correct recall of whether screening had been undertaken in the current pregnancy. In the usual care group, women receiving care in low-income settings were less likely to recall being offered diagnostic testing (adjusted odds ratio 0.23 [0.14-0.39]).CONCLUSION: Disparities exist in women's recall of prenatal genetic testing discussions and their understanding of their own experience. Interventions that explain testing options to women and help clarify their preferences may help to eliminate these differences.