Psychological consequences for parents of false negative results on prenatal screening for Down's syndrome: retrospective interview study

Abstract

Objective: To determine the psychological consequences for parents of children with Down's syndrome of having received a false negative result on prenatal screening.

Design: Comparison of adjustment of parents who received a false negative result with that of parents not offered a test and those who declined a test.

Setting: Parents were interviewed in their own homes.

Participants: Parents of 179 children with Down's syndrome (mean age 4 (range 2-6) years).

Main outcome measures: Anxiety, depression, parenting stress, attitudes towards the child, and attributions of blame for the birth of the affected child.

Results: Overall, regardless of screening history, parents adjusted well to having a child with Down's syndrome. Compared with mothers who declined a test, mothers in the false negative group had higher parenting stress (mean score 81.2 v 71.8, P=0.016, 95% confidence interval for the difference 1.8to 17.0) and more negative attitudes towards their children (124.9v 134.2, P=0.009, −16.2 to −2.4). Fathers in the false negative group had higher parenting stress test scores (77.8 v 70.0, P=0.046, 1.5 to 14.2) than fathers not offered a test. Mothers in the false negative group were more likely to blame others for the outcome than mothers who had not been offered the test (28% v 13%, P=0.032, 3% to 27%). Mothers and fathers in the false negative group were more likely to blame others for this outcome than parents who had declined a test (mothers 28% v 0%, P=0.001, 19% to 37%; fathers 27% v 0%, P=0.004, 17% to 38%). Blaming others was associated with poorer adjustment for mothers and fathers.

Conclusions: A false negative result on prenatal screening seems to have a small adverse effect on parental adjustment evident two to six years after the birth of an affected child.