Qualitative investigation of the factors that generate ambivalent feelings in women who give birth after receiving negative results from non-invasive prenatal testing

Abstract

Background: Women who receive negative results from non-invasive prenatal genetic testing (NIPT) may find that they later have mixed or ambivalent feelings, for example, feelings of accepting NIPT and regretting undergoing the test. This study aimed to investigate the factors generating ambivalent feelings among women who gave birth after having received negative results from NIPT. Methods: A questionnaire was sent to women who received a negative NIPT result, and a contents analysis was conducted focusing on ambivalent expressions for those 1562 women who responded the questionnaire. The qualitative data gathered from the questionnaire were analyzed using the N-Vivo software package. Results: Environmental factors, genetic counseling-related factors, and increased anticipatory anxiety, affected the feeling of ambivalence among pregnant women. Furthermore, pregnant women desired more information regarding the detailed prognosis for individuals with Down syndrome and living with them and/or termination, assuming the possibility that they were positive. Conclusions: Three major interrelated factors affected the feeling of ambivalence in women. Highlighting and discussing such factors during genetic counseling may resolve some of these ambivalences, thereby enhancing the quality of decisions made by pregnant women.

False-positives and false-negatives in non-invasive prenatal testing (NIPT): what can we learn from a meta-analyses on > 750,000 tests?

“…Again, it is a single Japanese study, which dealt with reasons why women were unsettled by NIPT, Yotsumoto et al [ 38 ] detail four major reasons as follows: lack of information from genetic counselling; feeling of social pressure not to have a child with a disability, especially T21; anxiety due to 2 weeks waiting for NIPT result coupled with an unawareness of doubts about the completeness of later obtained results; general doubts as " ‘options in the case of a positive result’, ‘guilt towards the child’, ‘criticisms on NIPT from others,’ ‘denial of disabled people’, and ‘how to tell the child’ “. …”

“…Again, it is a single Japanese study, which dealt with reasons why women were unsettled by NIPT, Yotsumoto et al [38] detail four major reasons as follows:…”

Change in client choice under multiple prenatal genetic testing options including noninvasive prenatal testing (NIPT) after genetic counseling in a Japanese maternity hospital

“…We examined how the clients who underwent genetic counseling (GC) at a primary maternity hospital offering multiple testing options selected or changed the aneuploidy test of choice. In Japan, it is mandatory to offer GC to clients who wish to undergo NIPT in certified institutes, 6 and it is considered to be of great benefit 9,10 . However, how GC should be performed in prenatal genetic testing is still under debate 9 .…”

Development and psychometric properties of the maternal ambivalence scale in spanish women

“…This coexistence of both positive and negative feelings associated with being a mother had led to the popularization of the term “maternal ambivalence”. Ambivalence refers to the presence of simultaneous conflictive reactions towards the same object, person or action curse, which is manifested at a cognitive, an affective, and/or a behavioural level [ 4 , 5 ]. While several definitions of ambivalence exist [ 6 – 9 ], two elements are key: (i) the presence of positive and negative associations about the same attitude and (ii) the same level of relevance in both associations, that is in positive and negative ones [ 10 ].…”