Maternal serum screening (MSS) in Newfoundland and Labrador: knowledge, opinion and practice

Abstract

Objective: To investigate maternal serum screening (MSS) in Newfoundland and Labrador. -- Design: Cross-sectional anonymous physician and post-partum women surveys conducted between September and December 2003. Aggregate laboratory data for 2003 were also assessed. -- Population: Physicians practicing antenatal care in Newfoundland and Labrador in the previous 12 months (n = 490). Women (n = 300) who had recently given birth. -- Results: The response rates for the physician and patient surveys were 60.4% (n = 293) and 66.7% (n = 200) respectively. Most physicians (88.8%) reported that they offer maternal serum screening to their patients. These physicians were divided among those who offered MSS to all women (63.5%) and those who offered MSS to selective groups of women (36.5%). Physicians who were younger, female and educated in Canada were more likely to offer MSS than physicians who were older, male and educated outside of Canada. Obstetricians were more likely to offer MSS and to offer the screening test to all women than family physicians. The majority of both physician groups reported that they would prefer a first trimester screening test. -- The majority (62.9%) of patients surveyed reported discussing MSS with their physician. Less than half (46.2%) of these women chose to undergo the prenatal screen. Women who underwent MSS were significantly older than women who did not undergo the screening test. Twenty seven percent of patients surveyed underwent MSS. -- Data obtained from the Provincial MSS Program indicated that 22% of women undergo MSS. The overall false positive rate 1 associated with MSS in Newfoundland and Labrador was 13.1%. -- Conclusion: MSS is not being used as a population based screening test. It is being offered to and used by selected groups of women. Further education and promotion of this prenatal screening test are necessary.