The "false positive" child in trisomy 21 screening: what effect on the mother's representations?

Context. Down syndrome is the most common chromosomal abnormality and is screened prenatally. The positive predictive value of this screening test implies that significant numbers of patients are affected by a false positive (about 26 000 women in 2013). Published data describes the anxiety the testing process can induce in mothers, but no study has investigated the impact of this anxiety on the mother-child relationship. The purpose of our study was to explore the experiences of patients and the impact on the mother-child relationship. Method. A qualitative study was conducted in women in a high risk group who had amniocentesis with normal fetal karyotype. The process was validated by an ethics committee. Coding was carried out on each interview, and data was collated. The results of the analysis were triangulated by the project director. Results. 17 semi-structured interviews were conducted. The patients in the study were asked to express the level of anxiety they had experienced at each of the different stages of the screening process : when they received the test result, during sampling of amniotic fluid, and whilst waiting for the results. This anxiety sometimes persisted after the birth. The patients were critical about the way of announcing. The impact on the ability of the mother to bond with the child after the birth was noted but would require further research. Conclusion. The "false positive" births following Down syndrome screening constitute a healthy population who have been subjected in utero to testing procedures which exposed them to high level of anxiety, as experienced by their mothers, at key points in their development. It is important that primary care practitioners are made aware of the potential for this anamnestic response so they are able to offer support and a listening ear to parents who would like the opportunity to talk about their experiences, and where necessary to refer patients on for further specialised conselling.