PB1397 - Psychological and cognitive factors involved in decision-making process of haemophilia carriers in reproductive choices

Background: Carriers of haemophilia (HCs), as an X-linked recessive trait, face a multitude of challenging reproductive decisions linked to the possibility of having an affected child, such as opting for pre‐implantation genetic testing (PGT), or choosing prenatal diagnosis (DPN) and then whether to continue or interrupt pregnancy in case of affected male fetus. Notwithstanding, the emotional and cognitive aspects of such decision-making processes were not explored in literature yet.

Aims: The aim of this study was to investigate whether cognitive and emotive factors, such as decision style1, risk perception2, coping strategies used in response to stress3 and emotions about haemophilia, might modulate HCs’ reproductive decisions.

Methods: Forty HCs were interviewed through questionnaires comprising standardized scales for psychological variables and ad-hoc open questions.

Results: Descriptive statistics about sociodemographic data, hemophilia-linked variables and pregnancy-related variables are reported in Table 1. Results for psychological tests are reported in Table 2.
A series of ANOVAs show that HCs who have a rational decision-making style tend to chose DPN or PGT, whereas those with an avoidant decision-making style tend to choose routine pregnancy analysis (RPA) (F=6.7, p=.002).
Moreover, the score to COPE is lower in women who chose DPN or PGT with respect to those who chose RPA (F=4.94, p=.025).
Although familial haemophilia does not impact, per se, on pregnancy decisions, women who chose DPN or PGT have deep negative emotions linked to haemophilia family history more frequently than those who chose RPA (F=13.42, p=.001).
As concerning pregnancy outcomes, the low number of haemophilic male foetuses (who might require a decision) do not allow to perform statistical analyses.

Conclusion(s): HCs who have a rational decision-making style, a low ability to cope with stressors, and who experienced discomfort, in childhood, for familial haemophilia, tend to choose PGT or DPN over RPA.