Key result
Shared interviews are linked to differing maternal-fetal health preferences driven by family member influence.
Why the study?
Quantitative data are limited on patient preferences for maternal and fetal health states arising from the use of anticoagulants in pregnancy.
When evaluating health states related to anticoagulant use in pregnancy, shared decision-making shifts preferences toward those of family members, with both groups prioritizing the avoidance of major fetal malformations and fetal death.
Answers are grounded in this paper and cite their sources.
Consider family when eliciting anticoagulation preferences in pregnancy; extends shared decision-making research but should not yet change practice.
Background: Quantitative data are limited on patient preferences for maternal and fetal health states arising from the use of anticoagulants in pregnancy. Objective(s): To obtain and compare preference values for combined maternal-fetal health states arising from anticoagulant use in pregnancy, through individual and shared interviews of pregnant individuals and their family members.Study Design: We conducted a cross-sectional study at a tertiary referral centre in Toronto, Canada from July to October 2015.Participants included pregnant individuals who were on anticoagulants, and their family members involved in medical decisionmaking.Participants were presented with seven scenarios regarding maternal and fetal health states.They first ranked these scenarios and then assigned values using a visual analogue scale, the time trade-off, and the standard gamble instruments on a scale of 0 -100, where 0 represented maternal and fetal death and 100 perfect maternal and fetal health.Results: Fifty-seven pregnant individuals and 43 family members were recruited, of which 40 pairs completed all interviews.There were significant differences between preferences based on different instruments, scenarios, and respondents.Among scenarios, 'perfect maternal health and minor fetal malformation' were consistently assigned highest score across all instruments [VAS 0.90 (0.79-0.95), TTO 1.00 (1.00-1.00),SG 1.00 (1.00 -1.00) for shared interviews].Preferences obtained through shared interviews showed a significant shift away from those obtained from pregnant individuals alone and towards those of family members.
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D'Souza et al. (2026) studied this question. Preferences for maternal-fetal health states differed significantly based on interview type, with family members' preferences influencing the outcome in shared interviews.
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