1. ¹King's College London, Institute of Psychiatry, Department of Psychology (at Guy's), Health Psychology Section, London, UK
2. ²Clinical & Molecular Genetics, Institute of Child Health and UCLH, London, UK
3. ³Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
4. ⁴Department of Obstetrics & Gynaecology, Prenatal diagnosis Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
5. ⁵Department of Obstetrics and Gynaecology, Prenatal Diagnosis Unit, Sant'Anna Hospital, Turin, Italy
6. ⁶Department of Medical Genetics & Fetal Medicine, University Hospital, Olomouc, Czech Republic
7. ⁷Genetics Subdivision, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
8. ⁸Department of Obstetrics and Gynaecology, 1st Affiliated Hospital of Kunming Medical College, Yunnan, China

Correspondence: Professor TM Marteau, King's College London, IOP, Department of Psychology (at Guy's), Health Psychology Section, 5th Floor, Thomas Guy House, London SE1 9RT, UK. Tel: +44 207 188 2590; Fax: +44 207 188 0195; E-mail: theresa.marteau@kcl.ac.uk

Received 11 October 2006; Revised 9 January 2007; Accepted 11 January 2007; Published online 21 February 2007.

Abstract

To date, studies assessing whether the information given to people about screening tests facilitates informed choices have focussed mainly on the UK, US and Australia. The extent to which written information given in other countries facilitates informed choices is not known. The aim of this study is to describe the presentation of choice and information about Down's syndrome in written information about prenatal screening given to pregnant women in five European and two Asian countries. Leaflets were obtained from clinicians in UK, Netherlands, Spain, Italy, Czech Republic, China and India. Two analyses were conducted. First, all relevant text relating to the choice about undergoing screening was extracted and described. Second, each separate piece of information or statement about the condition being screened for was extracted and then coded as either positive, negative or neutral. Only Down's syndrome was included in the analysis since there was relatively little information about other conditions. There was a strong emphasis on choice and the need for discussion about prenatal screening tests in the leaflets from the UK and Netherlands. The leaflet from the UK gave most information about Down's syndrome and the smallest proportion of negative information. By contrast, the Chinese leaflet did not mention choice and gave the most negative information about Down's syndrome. Leaflets from the other countries were more variable. This variation may reflect cultural differences in attitudes to informed choice or a failure to facilitate informed choice in practice. More detailed studies are needed to explore this further.