British Journal zyxwvuts of Obstetrics and Gynaecology zyxwvut June zyxwvutsrqp 1988, Vol. 95, pp. 56&564 Factors affecting the uptake of screening for neural tube defect DOROTHY KYLE, CAROLE CUMMINS, STUART EVANS Summary. A questionnaire concerning pregnant women’s knowledge of, and attitudes to, serum alpha fetoprotein (AFP) screening for spina bifida was sent to all pregnant women receiving a health education leaflet on AFP screening who booked at the Birmingham Maternity Hospital in the first quarter of 1984. The majority said that they would accept the test, and subsequently did so. This suggests that low uptake of the test is not a result of patients’ resistance, and the results indicated that the provision of early information about the test is likely to improve uptake and decrease anxiety. With the increasing clinical usefulness of the AFP test, routine screening of pregnant women with an ‘opt-out‘ system is becoming clinically desirable, and the survey suggests that it would be acceptable to the patients. A serum alpha fetoprotein (AFP) screening ser- vice is available for all pregnant women in the West Midlands Regional Health Authority, yet in 1984 only about half of them were tested. To determine how far poor uptake was related to the patient’s behaviour and patient’s resis- tance, it was decided to survey pregnant women’s attitudes to, and knowledge of, screen- ing for neural tube defects. It was expected that this would also suggest ways in which the organ- ization and timing of screening might promote up take. Central Birmingham Health Authority, District Office, Vincent Drive, Edgbaston, Birmingham B15 2TZ DOROTHY KYLE zyxwvutsrq Speciulisl in Community Medicine Health Services Research Centre, Department of Social Medicine, University zyxwvuts of Birmingham, Fdgbaston, Birmingham B15 2TJ CAROLE CUMMINS Research Associufe Birmingham Maternity Hospital, The Queen Elizabeth Medical Centre, Birmingham 15 STUART EVANS Principal Biochemisi Correspondence: Dorothy Kyle 560 Patients and methods All 1235 patients booking at the Birmingham Maternity Hospital in the first quarter of 1984 who were sent the standard leaflet about AFP screening (West Midlands Regional zy . Health Authority Public Relations Department. Screening for Spina B(fidu) were also sent a ques- tionnaire designed both to explore their atti- tudes to and knowledge of screening for neural tube defects and also to assess the value of the leaflet. They were asked to hand the completed questionnaire to the booking clerk on their booking attendance. When the questionnaires were returned, the clerk was usually able to attach a patient identification label to the envel- ope which enabled questionnaires to be linked to AFP test records for 1984. As the questionnaires were collected at the first hospital visit, the women’s answers were not influenced by any- thing that they heard at hospital during their current pregnancies. Overall, 957 question- naires were returned, a response rate of 77.5%. Percentages in the text and tables refer to respondents to specific questions: response rates to individual questions were invariably high.