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How important is consent in maternal serum screening for Down syndrome in France? Information and consent evaluation in maternal serum screening for Down syndrome: a French study.
Favre R., Duchange N., Vayssière C., Kohler M., Bouffard N., Hunsinger M.-C., Kohler A., Mager C., Neumann M., Vayssière C. et al
Prenat Diagn 27, 3 (2007) 197-205 - http://www.hal.inserm.fr/inserm-00126553
(17238219)
How important is consent in maternal serum screening for Down syndrome in France? Information and consent evaluation in maternal serum screening for Down syndrome: a French study.
Romain Favre () 1, Nathalie Duchange2, Christophe Vayssière1, Monique Kohler1, Nicole Bouffard1, Marie-Christine Hunsinger1, Anne Kohler1, Cécile Mager1, Muriel Neumann1, Christine Vayssière1, Brigitte Viville1, Christian Hervé2, Grégoire Moutel2
1 :  Département d'échographie et de Médecine fœtale
SIHCUS-CMCO
19 rue Louis Pasteur Schiltigheim, Strasbourg
France
2 :  LEM - Laboratoire d'éthique médicale et médecine légale
Université Paris V - Paris Descartes
Faculté de médecine, 45 rue des Saints-Pères, Paris 75006
France
OBJECTIVES: To evaluate the level of information and informed consent for maternal serum screening (MSS) for Down syndrome (DS) in the second trimester of pregnancy and analyse the exercise of autonomy towards the test by the women concerned. METHODS: We studied the population of pregnant women attending obstetric consultations in two French hospitals over a 3-month period. The women were assigned to three groups according to MSS results for DS: women at high risk of having a child with DS (group 1), women at low risk (group 2) and women who did not undergo the test (group 3). A questionnaire was completed before the medical consultation, to assess the quality of consent before amniocentesis for the group at high risk and before the second-trimester ultrasound scan for the other two groups. RESULTS: We analysed 305 questionnaires for 89, 137 and 79 women belonging to groups 1, 2 and 3 respectively. In total, 123 women (40.3% [IC 95%, 35-46%]) were considered to be well informed; 33 (10%, [IC 95%, 8-12%]) had a high level of knowledge, but made choices not consistent with their stated attitude, and 149 (49.7% [IC 95%, 45-56%]) were considered uninformed. Logistic regression analysis showed that maternal consent depended on three independent components: The score attributed to the doctor for information about MSS (t = 4.216, p < 0.001).Whether the patient belonged to group 1 (t = -2.631, p < 0.009).Educational level (< high-school diploma, high-school diploma or at least two years of higher education after high school) (t = 2.324, p < 0.02). The rate of consent increased with educational level and was highest for the women in group 1 and for those whose doctor had a high information score. CONCLUSIONS: Our findings clearly show that women are provided with insufficient information concerning MSS screening for DS in the second trimester of pregnancy for real and valid consent to be obtained. Copyright (c) 2007 John Wiley & Sons, Ltd.
Sciences du Vivant/Ethique
Sciences du Vivant/Médecine humaine et pathologie/Gynécologie et obstétrique
Anglais
0197-3851

Articles dans des revues avec comité de lecture
10.1002/pd.1656
Prenat Diagn
24/01/2007
08/06/2007
27
3
197-205

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