Prenatal diagnosis for psychological reasons: comparison with other indications, advanced maternal age and known genetic risk.

In Sweden, about 20 per cent of women undergoing prenatal diagnosis (PND) have the test for 'psychological reasons', which means that they strongly fear giving birth to a disabled child, but have not reached the age limit. Women undergoing amniocentesis or chorionic villus biopsy for these reasons (n = 38) were studied by questionnaires with regard to distress during test procedures. They were compared to women examined because of a known or strongly suspected high risk of giving birth to a congenitally disabled child (n = 27) and to women examined because of an age more than 37 years (n = 144). The most distressed were women who had a high genetic risk. The women who had the test because of their age reported less distress. Women examined for psychological reasons, were moderately distressed, but reported the highest frequency of influence by the distress on their daily living. Women in all groups, however, felt a similar support by the normal test result and reported the whole procedure as rather easy. Different psychological determinants of anxiety of giving birth to a disabled child are discussed. The 'psychological indication' for PND means that the women's private interpretation of her risk, and not only the statistical limit, motivates PND.