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

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7232.407 (Published 12 February 2000) Cite this as: BMJ 2000;320:407

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Characteristics of mothers who refuse prenatal test need to be considered

EDITOR - Hall1 reports that mothers receiving a false negative result
had higher parenting stress and more negative attitudes towards their
children with Down's Syndrome compared with those who declined a test.

However, before we conclude of a possible causal link we must consider
further the characteristics of mothers who refuse a prenatal test. Is it a
reasonable hypothesis that these mothers will have more positive attitudes
to their children and exhibit less parenting stress than mothers who
choose a test? Without adjusting for these baseline characteristics the
study could be biased and the difference in means shown by Hall may be
overestimates. Given the non significant outcomes of anxiety and
depression there seems little convincing evidence of a psychological
effect of a false negative result.

Also, the comparison with the third group, 'test not offered' is confused
by the fact that this group will contain both potential 'false negative's
and potential 'test declined's , it will be hard to assign an association
between test outcome and attitudes towards children with these groups.

Hall have raised an interesting question of whether there is a disparity
between statistical and clinical importance of a test's sensitivity but we
cannot begin to answer this question without knowing the psychological
characteristics of mothers who refuse a screening test

Paul Wicks

Senior Biostatistician

Department of Psychiatry,
St George's Hospital Medical School,
Cranmer Terrace,
Tooting, London
SW17 0RE

1. Hall S, Bobrow M, Marteau TM. Psychological consequences for
parents of false negative results on prenatal screening for Down's
syndrome: retrospective interview study. BMJ 2000;320:407-412 (February
12th)

Competing interests: No competing interests

23 February 2000
Paul Wicks