From consent to understanding: Effect of an illustrated brochure on knowledge about first trimester Down syndrome screening Del consentimiento a la comprensión: efecto de un folleto ilustrado sobre el conocimiento del cribado del síndrome de down en el primer trimestre
Clinica e Investigacion en Ginecologia y Obstetricia, cilt.53, sa.3, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 53 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.gine.2026.101126
- Dergi Adı: Clinica e Investigacion en Ginecologia y Obstetricia
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, DIALNET
- Anahtar Kelimeler: Down syndrome, First-trimester screening, Patient counseling, Perceived Stress Scale
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: Pregnant women often misunderstand the purpose and implications of first-trimester Down syndrome screening. We evaluated whether a simple, illustrated brochure could improve women's knowledge without increasing perceived stress. Methods: This prospective observational study was conducted in a tertiary antenatal clinic among women attending for first-trimester combined screening. On odd calendar days, women received routine written information and consent plus a patient-friendly brochure (intervention group); on even days, women received routine information alone (control group). All literate women aged 18–45 years with singleton pregnancies who agreed to participate completed a 10-item multiple-choice knowledge questionnaire and the 10-item Perceived Stress Scale (PSS-10) after a 20-min reading period. Primary outcomes were total knowledge score (0–10) and PSS-10 score (0–40). Results: Of 328 eligible women, 304 (92.7%) provided complete data (148 intervention, 156 control). Groups were comparable in age, gravidity, parity, education, and employment. Self-reported reading of the standard consent form was low in both groups (33% vs 39%). Mean knowledge scores were higher in the brochure group than in controls (5.51 ± 2.18 vs 4.87 ± 2.22; p = 0.008). The benefit was most pronounced among women with primary or high-school education and among nulliparas; university-educated women showed no improvement. Mean PSS-10 scores indicated moderate stress in both groups (14.6 ± 8.7 vs 15.1 ± 8.7; p = 0.54), with no association between stress and parity or educational level. Discussion: A brief, visually supported brochure modestly improved understanding of first-trimester combined screening, particularly in women with lower educational attainment, without affecting perceived stress. The single-center design, use of a nonvalidated knowledge questionnaire, and exploratory subgroup analyses limit generalizability, but findings support incorporating concise decision-support materials into routine antenatal care and warrant confirmation in larger, randomized, multi-center studies.