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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: (Published 12 February 2000) Cite this as: BMJ 2000;320:407

Rapid Response:

Psychological consequences of a false negative antenatal screening result

Hall et al’s finding that parents who have a Down syndrome child born
after receiving a false negative antenatal screening result have greater
problems adjusting should come as no surprise to health care staff who
have to deal with affected families. As the paediatrician who deals with
all Down syndrome births in my district, my first response when faced with
a new case is to ask. “was the mother offered screening? If so what was
the result?”

The reaction of parents must be seen not as just an outcome of
specific screening efforts targeted at Down syndrome, but rather, in the
context of the general process of care during pregnancy. Antenatal care
has come to be seen as a highly technical process of identifying deviation
from the normal and predicting the likelihood of an adverse outcome. At
each encounter with the health service prospective parents are given a
prognosis - usually a cheery one. What to the doctor or midwife is an
absence of evidence of a specific abnormality is translated in the process
of this interaction to a confident prediction of normality. It is small
wonder therefore that when things do go wrong, they are seen as serious
shortcomings in the system.

The authors are to be congratulated for the depth of their study. I
was surprised therefore to find no data on the ethnic group, or degree of
familiarity with English, of the families involved. In my experience it is
even more problematic, even with interpreters, to communicate concepts of
‘risk’, ‘chromosomal abnormality’ or ‘inborn error of metabolism’ to
parents who do not speak English.

Vidya Rao FRCPCH

Consultant Paediatrician

Walsall Community Health Trust,
Brace Street Health Centre,


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. (12 February)

Competing interests: No competing interests

23 February 2000
Vidya Rao
Consultant Paediatrician