Miscarriage after invasive prenatal diagnostic procedures: how much risk our pregnant women are willing to take?

• Published in: Prenatal diagnosis 2009-09, Vol.29 (9), p.870-874
• Main Authors: Chan, Yiu Man, Sahota, Daljit Singh, Chan, Oi Ka, Leung, Tak Yeung, Lau, Tze Kin
• Format: Article
• Language: English
• Subjects: Abortion, Spontaneous - epidemiology; Abortion, Spontaneous - etiology; Abortion, Spontaneous - psychology; Adult; Biological and medical sciences; China; Chinese; Delivery. Postpartum. Lactation; Female; Fundamental and applied biological sciences. Psychology; Genetics of eukaryotes. Biological and molecular evolution; Gynecologic Surgical Procedures - adverse effects; Gynecologic Surgical Procedures - psychology; Gynecologic Surgical Procedures - statistics & numerical data; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Molecular and cellular biology; preferences; Pregnancy; Pregnant Women - psychology; Prenatal Diagnosis - adverse effects; Prenatal Diagnosis - methods; Prenatal Diagnosis - psychology; Prenatal Diagnosis - statistics & numerical data; prenatal diagnosis tests; Risk-Taking; Social Class; standard gamble metrics
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.2305

Objectives To elicit the level of risk of prenatal diagnostic procedure‐related miscarriage that Chinese pregnant women were willing to accept. Methods An interviewer‐administered survey was conducted on 276 women who presented to the University Obstetric Unit. Using the standard gamble approach, subjects were asked to choose between a screening test with a 90% detection rate and a diagnostic test which is definitive but carries a finite risk of abortion. This probability of abortion was varied until the subject was indifferent between the two choices, and the value was called the utility score. Results When compared with a screening test with 90% detection rate, the median utility score was 0.989 (IQR: 0.970–0.999). The median risk of abortion below which the subjects would rather opt for an invasive test instead of a screening test was 1.1%. The percentage of patients who could accept a procedure‐related miscarriage risk of 0.2, 0.5, 1 and 2% were 76, 67, 59.8 and 38.4%, respectively. Conclusions Pregnant Chinese women agreed to trade a definitive chromosomal diagnostic test from a highly effective screening test with a small risk of undiagnosed aneuploidy provided that the procedure‐related miscarriage risk was 1.1% or lower. Copyright © 2009 John Wiley & Sons, Ltd.