Assessing Health-Related Quality-of-Life in Prenatal Diagnosis Comparing Chorionic Villi Sampling and Amniocentesis: A Technical Report

Objectives. To assess the health-related quality-of-life (HRQL) effects of chorionic villi sampling (CVS) and genetic amniocentesis (GA) prenatal diagnosis, including factors related to both the processes and the outcomes. Study Design. The HRQL of one hundred twenty six women participating in a randomized controlled clinical trial of CVS versus GA in Toronto and Hamilton, Ontario was assessed in four interviews at weeks 8, 13, 18, and 22 of pregnancy. Statistical analyses included analysis of variance, repeated measures analysis of covariance, chi-square, Fisher’s exact test, Student’s t-tests, and paired t-tests. Results. Utility scores for patients undergoing CVS exceeded those for GA patients at week 18 (p = 0.04). Utility scores for hypothetical health states did not differ significantly by trial arm. Conclusions. CVS results in slightly improved HRQL relative to GA during the second trimester of pregnancy. This advantage needs to be weighed against the high disutility patients attach to infrequent outcomes associated with pregnancy losses, equivocal diagnoses, and diagnostic inaccuracy.