Research article

Women's attitude towards prenatal screening for red blood cell antibodies, other than RhD

JM Koelewijn^1,2 , TGM Vrijkotte² , M de Haas¹ , CE van der Schoot^1,2 and GJ Bonsel^3,2

¹  Sanquin Research, Amsterdam, and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Plesmanlaan 125, 1066 CX Amsterdam, The Netherlands

²  Academic Medical Centre, Department of Social Medicine, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

³  Institute Health Policy and Management, Erasmus Medical Centre, Postbox 1738, 3000 DR Rotterdam, The Netherlands

author email corresponding author email

BMC Pregnancy and Childbirth 2008, 8:49doi:10.1186/1471-2393-8-49

Published:	11 November 2008

Abstract

Background

Since July 1998 all Dutch women (± 200,000/y) are screened for red cell antibodies, other than anti-RhesusD (RhD) in the first trimester of pregnancy, to facilitate timely treatment of pregnancies at risk for hemolytic disease of the fetus and newborn (HDFN). Evidence for benefits, consequences and costs of screening for non-RhD antibodies is still under discussion. The screening program was evaluated in a nation-wide study. As a part of this evaluation study we investigated, according to the sixth criterium of Wilson and Jüngner, the acceptance by pregnant women of the screening program for non-RhD antibodies.

Methods

Controlled longitudinal survey, including a prenatal and a postnatal measurement by structured questionnaires. Main outcome measures: information satisfaction, anxiety during the screening process (a.o. STAI state inventory and specific questionnaire modules), overall attitude on the screening program. Univariate analysis was followed by standard multivariate analysis to identify significant predictors of the outcome measures. Participants: 233 pregnant women, distributed over five groups, according to the screening result.

Results

Satisfaction about the provided information was moderate in all groups. All screen- positive groups desired more supportive information. Anxiety increased in screen- positives during the screening process, but decreased to basic levels postnatally. All groups showed a strongly positive balance between perceived utility and burden of the screening program, independent on test results or background characteristics.

Conclusion

Women highly accept the non-RhD antibody screening program. However, satisfaction about provided information is moderate. Oral and written information should be provided by obstetric care workers themselves, especially to screen-positive women.