Preferences of Pregnant Women and Family Members for Maternal-fetal Health States

INTRODUCTION: Our objective was to determine whether pregnant women and their family members choose differently when making medical decisions in pregnancy. METHODS: We conducted a cross-sectional study on pregnant women with chronic medical conditions and their family members involved in medical decision making, seen at Mount Sinai Hospital, Toronto. Participants were presented with seven vignettes related to the maternal and fetal outcomes related to the use of anticoagulants in pregnancy. Preferences values were obtained between 0-100 (zero representing death and 100 representing perfect health), using the visual analogue scale (VAS) and the standard gamble (SG). RESULTS: 32 pregnant women, 31 family members, and 32 pairs completed the study. The median age for pregnant women and their family members was 32.5 and 35 years respectively. Most were in partnered relationships, Caucasian, of North American descent, educated, employed with combined annual incomes ≥100 000 Canadian Dollars and risk-averse. While preference values obtained from combined interviews by VAS showed no distinct pattern, those obtained by the SG were closer to those of the family member. . The health-state with the highest preference value was “mother ok, minor fetal malformation” while the lowest involved maternal blood clot with either a major fetal malformation or fetal loss. CONCLUSION: Preference values for maternal-fetal health-states obtained through shared interviews with pregnant women and their family members are closer to those of the family member than the pregnant woman. Reasons for these differences are being explored as part of a qualitative study.