Determinants associated with making prenatal screening decisions in a national study

• Published in: Journal of obstetrics and gynaecology 2019-01, Vol.39 (1), p.41-48
• Main Authors: Bakst, Shelly, Romano-Zelekha, Orly, Ostrovsky, Jenny, Shohat, Tamy
• Format: Article
• Language: English
• Subjects: Abortion, Induced - psychology; Adult; Arabs - psychology; Arabs - statistics & numerical data; birth related choices; Childbirth & labor; Culturally Competent Care; Decision Making; Female; foetal aberrations; Genetic Testing - statistics & numerical data; Health Knowledge, Attitudes, Practice; Humans; Israel; Jewish people; Jews - psychology; Jews - statistics & numerical data; Medical diagnosis; non-invasive screening decisions; Postpartum Period - psychology; Pregnancy; pregnancy termination; Prenatal diagnosis; Prenatal Diagnosis - psychology; Prenatal Diagnosis - statistics & numerical data; prenatal screening; Retrospective Studies; Ultrasonic imaging
• ISSN: 0144-3615; 1364-6893
• DOI: 10.1080/01443615.2018.1463977

This study sought to evaluate the associations between background exposures and psychological determinants, among postpartum Jewish and Arab women, relative to actual prenatal test endorsement. The independent and aggregative effects of contextual features and the subjective opinions and attitudes relative to a prenatal testing were evaluated, using logistic regressions. After accounting for contextual features, Jews with positive vs. negative opinions on screening were significantly more likely to undergo a prenatal screening. Specifically, having more favourable ideas on pregnancy termination, among Jews, was associated with a greater likelihood of triple test, nuchal translucency and ultrasound uptake as compared with those that refused. Similarly, Arabs who were more inclined to abort the pregnancy had a greater chance of using nuchal translucency and ultrasound vs. those that declined testing. As the preferences for prenatal test outcomes are multifaceted and vary according to population group, a better understanding of the factors involved in making testing choices could help ease the decision-making process. Impact Statement What is already known on this subject? The choice to undergo prenatal screening tests is influenced by various determinants, which include: social, demographic and emotional factors that vary by cultural preferences. Indeed, women integrate (subjective) beliefs and values that extend beyond rational (objective) reasoning when estimating whether or not to undergo testing. It may then be that, prenatal test choices might be, influenced less by actual risk status and more so by emotional factors. And while, the latter are more likely to be amendable, and thus influence changes in perception, the effect of psychological exposures on the decision making process in the genetic testing context, especially among Israeli Jews and Arabs, has been understudied. What the results of this study add? The current study extends the focus by addressing the role of evaluative beliefs and emotional factors involved with formulating prenatal screening judgments relative to actual testing among individuals with diverse profiles (Israeli Jews and Arabs). What was clarified was that background factors and psychological perceptions, such as having supportive attitudes on screening and a willingness to undergo abortion were, for the most part, related to prenatal test uptake. Concomitantly, these involve dense decision-making practices that can be diffic