877: The association between patient characteristics and psychological experiences when deciding about prenatal genetic diagnostic testing

The decision to pursue prenatal genetic diagnostic testing (PGDT) can be psychologically challenging, with influence from family or cultural constructs. Our objective was to determine if selected patient characteristics are associated with the degree of distress, certainty, and decisional clarity when considering PGDT. Cross-sectional design. Patients were given a voluntary, anonymous questionnaire (Q) assessing the decision-making process in regards to invasive (CVS and/or amniocentesis) PGDT. Qs were distributed from 2017-2019 to those referred for genetic testing. Questions (44 total, 5-point Likert scale with 0-4 range) were structured to evaluate patient decisional certainty, distress, and clarity on the pros/cons, and were partly adapted from published validated Q’s. Exclusion criteria: English or Spanish illiterate. Means, variances (SD), and ranges were tabulated. 3 variables were examined a priori for potential influence on the Q responses. 44 patients completed the Q (77% white, 45% Catholic, 35% less than college degree). 25% were nulliparous and 25% were undecided as whether to pursue PGDT. See Table 1. There was no significant difference in regards to distress (p=0.37), decisional clarity (p=0.16) or certainty (p=0.50) between Catholics and non-Catholics. There was no significant difference in regards to distress (p=0.37), decisional clarity (p=0.40) or certainty (p=0.82) between nulliparous vs. multiparous patients. Greater distress (1.6±0.75 v 1.1±0.78, p< 0.05) and less decisional clarity (2.7±1.36 v 3.5±0.64, p=0.07) were noted between those who were still debating PGDT testing vs those who had decided. In this group, there was no statistically significant difference in decisional certainty scores (p=0.17). Women who are in the midst of the decision reported greater distress and less clarity. This information suggests that provider counseling and follow up of patients in proximity to the PGDT recommendation may be beneficial. Future studies can investigate other patient characteristics that may influence decision making for PGDT.