What participants understand about a maternal serum alpha-fetoprotein screening program

Abstract

We investigated the knowledge of pregnant women participating in a maternal serum alphafetoprotein (MSAFP) screening program for the detection of neural tube defects (NTDs) in the fetus. Women participating in the screening program scored higher on two knowledge tests than a comparison group of pregnant women who were not offered screening. However, there were substantial gaps in the knowledge base of women in the program, as measured by one of the tests. Women did not misinterpret a negative test result to mean that the test had identified a potential problem with the fetus; instead, there is a suggestion that they tended to interpret a negative result too positively, as an assurance that the baby was healthy in all respects.

KIE: Pregnant women participating in a maternal serum alpha-fetoprotein (AFP) screening program for the detection of fetal neural tube defects were interviewed to evaluate their understanding of the test, the defects, and the meaning of test results. Although women participating in the screening program scored higher on two knowledge tests than a comparison group not offered screening, there were substantial gaps in knowledge. Poor performance on the free response test (in which definitions of terms were requested) raises concerns about the adequacy of the women's consent to screening. They understood that a positive test result would entail having to make a decision about abortion, but seemed to have interpreted a negative test as an assurance that the baby was healthy in all respects.